MEDICARE: DR. SRINO BHARAM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	203659	NY

General Provider Information

NPI Number	:	1104828805
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SRINO BHARAM MD

Provider Business Mailing Address
First Line	:	130 E 77TH ST
Second Line	:	BLACK HALL 8TH FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10075-1851
Country	:	US
Telephone Number	:	212-691-3535
Fax Number	:	212-691-6370

Provider Business Practice Location Address
First Line	:	130 E 77TH ST
Second Line	:	BLACK HALL 8TH FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10075-1851
Country	:	US
Telephone Number	:	212-691-3535
Fax Number	:	212-691-6370

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	12/10/2013

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