MEDICARE: DR. SREELATHA NAIK 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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	MD459128	PA

General Provider Information

NPI Number	:	1689808594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SREELATHA NAIK MD

Provider Business Mailing Address
First Line	:	100 NORTH ACADEMY AVENUE
Second Line	:
City	:	DANVILLE
State	:	PA
Zip	:	17822-4903
Country	:	US
Telephone Number	:	570-271-6144
Fax Number	:	570-271-6578

Provider Business Practice Location Address
First Line	:	1000 EAST MOUNTAIN BLVD
Second Line	:
City	:	DANVILLE
State	:	PA
Zip	:	18711-3478
Country	:	US
Telephone Number	:	570-808-7861
Fax Number	:	570-808-1069

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

Provider Enumeration Date	:	05/06/2009
Last Update Date	:	09/01/2020

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