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General NPI Number Information
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NPI Number | 1265839336
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Entity Type | Individual
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Provider Name | SRITHARANI KANDASAMY M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/04/2014
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Last Update Date | 01/18/2023
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Provider Practice Location Address
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Address Line | 230 WORCESTER ST
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City | WELLESLEY
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State | MA
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Zip | 02481-5420
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Country | US
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Telephone | 781-431-5429
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Fax | 781-431-5548
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Provider Business Mailing Address
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Address Line | 230 WORCESTER ST
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City | WELLESLEY
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State | MA
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Zip | 02481-5420
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Country | US
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Telephone | 781-431-5429
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Fax | 781-431-5548
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 83150
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License Number State | ZZ
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 261690
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License Number State | MA
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