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Contact Information

GANGADHARA R KABBLI, MD
1243 PENNSYLVANIA AVE
PINE CITY, NY14871
 Phone: 607-734-6281
 Fax: 607-734-4409
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for GANGADHARA R KABBLI · (Male)

NPI # 1841337672
Status Active
Credentials MD
Entity Individual
Enumeration date 01/31/2007
Last updated 07/31/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 262909
  • NY Medicaid 03397880
  • PA Medicaid 1032498220002
Hospital affiliation(s)
  • AUBURN COMMUNITY HOSPITAL - (Acute Care)
    17 LANSING STREET
    AUBURN, NY 13021
  • OSWEGO HOSPITAL - (Acute Care)
    110 WEST SIXTH STREET
    OSWEGO, NY 13126
  • ST JOSEPH'S HOSPITAL HEALTH CENTER - (Acute Care)
    301 PROSPECT AVENUE
    SYRACUSE, NY 13203
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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