Healthcare Provider Details

I. General information

NPI: 1841487923
Provider Name (Legal Business Name): SR MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2007
Last Update Date: 01/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 NEW RD
MONMOUTH JUNCTION NJ
08852-2653
US

IV. Provider business mailing address

462 NEW RD
MONMOUTH JUNCTION NJ
08852-2653
US

V. Phone/Fax

Practice location:
  • Phone: 732-274-2557
  • Fax: 732-274-6777
Mailing address:
  • Phone: 732-274-2557
  • Fax: 732-274-6777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SARITHA REGULAPATI
Title or Position: PRINCIPAL
Credential: M.D.
Phone: 732-274-2557