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General NPI Number Information
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NPI Number | 1174523021
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Entity Type | Individual
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Provider Name | SRINIVASAN KRISHNA MD
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Gender | Male
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Dates
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Enumeration Date | 07/21/2005
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Last Update Date | 08/03/2007
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Provider Practice Location Address
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Address Line | 1650 SELWYN AVE 11C
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City | BRONX
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State | NY
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Zip | 10457-7626
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Country | US
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Telephone | 718-866-8161
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Fax | 718-518-5785
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Provider Business Mailing Address
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Address Line | 1650 SELWYN AVE SUITE 11C
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City | BRONX
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State | NY
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Zip | 10457-7626
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Country | US
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Telephone | 718-866-8161
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Fax | 718-518-5785
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 235552
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License Number State | NY
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