MEDICARE: SRILAKSHMI KADIYALA

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	207Q00000X	Family Medicine Physician	003585	NY

General Provider Information

NPI Number	:	1952616724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SRILAKSHMI KADIYALA

Provider Business Mailing Address
First Line	:	930 GRAND CONCOURSE
Second Line	:	APT #10E
City	:	BRONX
State	:	NY
Zip	:	10451-2705
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	930 GRAND CONCOURSE
Second Line	:	APT #10E
City	:	BRONX
State	:	NY
Zip	:	10451-2705
Country	:	US
Telephone Number	:	718-316-1562
Fax Number	:

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

Provider Enumeration Date	:	08/17/2010
Last Update Date	:	10/10/2023

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Directions to “ SRILAKSHMI KADIYALA ” Practice Location

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