Healthcare Provider Details

I. General information

NPI: 1992820955
Provider Name (Legal Business Name): SELVI SRIRANGANATHAN M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 PETER JEFFERSON PKWY SUITE 190
CHARLOTTESVILLE VA
22911-8835
US

IV. Provider business mailing address

600 PETER JEFFERSON PKWY SUITE 190
CHARLOTTESVILLE VA
22911-8835
US

V. Phone/Fax

Practice location:
  • Phone: 434-220-8622
  • Fax: 434-220-8625
Mailing address:
  • Phone: 434-220-8622
  • Fax: 434-220-8625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: