Healthcare Provider Details

I. General information

NPI: 1922230523
Provider Name (Legal Business Name): SRIKANTH PARSI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2009
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BOWMAN DR STE E355
VOORHEES NJ
08043
US

IV. Provider business mailing address

301 LIPPINCOTT DR STE 410
MARLTON NJ
08053-4197
US

V. Phone/Fax

Practice location:
  • Phone: 856-247-7295
  • Fax: 856-247-7511
Mailing address:
  • Phone: 856-247-7295
  • Fax: 856-247-7511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number25MA10337400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: