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Contact Information

SIRISH K KONDABOLU
912 RUSSELL DR
LEBANON, PA17042
 Phone: 717-272-7971
 Fax: 717-272-1241
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for SIRISH K KONDABOLU · (Male)

NPI Number 1821354176
Status Active
Credentials
Entity Individual
Enumeration date 04/11/2012
Last updated 01/18/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 275452
  • PA License # MD465257
Hospital affiliation(s) Not Available
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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