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NPI Code Detail

MEDICARE: MRS. SRIREKHA DAYANIDHI PAC

MEDICARE:  MRS. SRIREKHA  DAYANIDHI  PAC
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
1363A00000XPhysician Assistant
2363AM0700XMedical Physician Assistant25MP00088300NJ

General Provider Information

NPI Number : 1629018825
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SRIREKHA DAYANIDHI PAC
Provider Business Mailing Address
First Line : 301 LIPPINCOTT DR STE 410
Second Line :
City : MARLTON
State : NJ
Zip : 08053-4197
Country : US
Telephone Number : 856-355-0340
Fax Number : 856-355-0330
Provider Business Practice Location Address
First Line : 107 BERLIN RD
Second Line :
City : CHERRY HILL
State : NJ
Zip : 08034-3526
Country : US
Telephone Number : 856-429-1800
Fax Number : 856-429-1081
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2006
Last Update Date : 09/20/2024

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Directions to “ MRS. SRIREKHA DAYANIDHI PAC” Practice Location

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