MEDICARE: DR. TULASI SRINIVASA KUMAR GORIPARTHI M.D

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	2084P0800X	Psychiatry Physician	39020000X	NY

General Provider Information

NPI Number	:	1316355506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TULASI SRINIVASA KUMAR GORIPARTHI M.D

Provider Business Mailing Address
First Line	:	79-01 BROADWAY ELMHURST
Second Line	:	PSYCHIATRY DEPARTMENT, ELMHURST HOSPITAL CENTER
City	:	NEW YORK
State	:	NY
Zip	:	11373
Country	:	US
Telephone Number	:	718-334-3542
Fax Number	:

Provider Business Practice Location Address
First Line	:	79-01 BROADWAY ELMHURST
Second Line	:	PSYCHIATRY DEPARTMENT, ELMHURST HOSPITAL CENTER
City	:	NEW YORK
State	:	NY
Zip	:	11373
Country	:	US
Telephone Number	:	718-334-3542
Fax Number	:

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

Provider Enumeration Date	:	07/31/2014
Last Update Date	:	07/31/2014

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