Healthcare Provider Details

I. General information

NPI: 1851092662
Provider Name (Legal Business Name): SRUTHI SEKARAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2023
Last Update Date: 03/17/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 LANSDOWNE AVE
DARBY PA
19023-1200
US

IV. Provider business mailing address

778 E PROVIDENCE RD APT 108B
ALDAN PA
19018-4337
US

V. Phone/Fax

Practice location:
  • Phone: 610-237-4684
  • Fax:
Mailing address:
  • Phone: 215-594-6272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: