| Amulya Ponna, | |
|
6062 Ridge Ave, Philadelphia, PA 19128-1647 | |
| (212) 385-3700 | |
| Not Available |
| Full Name | Amulya Ponna |
|---|---|
| Gender | |
| Speciality | Physician Assistant |
| Experience | 1 Years |
| Location | 6062 Ridge Ave, Philadelphia, Pennsylvania |
| Accepts Medicare Assignments | Yes. This provider accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831068683 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | (* (Not Available)) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Dermatology Specialists Of Delaware Llc | 8224503396 | 7 |
| Entity Name | Dermatology Specialists of Delaware LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275309015 PECOS PAC ID: 8224503396 Enrollment ID: O20260407000121 |
| Mailing Address | Practice Location Address |
|---|---|
| Amulya Ponna, 6062 Ridge Ave, Philadelphia, PA 19128-1647 Ph: (610) 458-7365 | Amulya Ponna, 6062 Ridge Ave, Philadelphia, PA 19128-1647 Ph: (212) 385-3700 |
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