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General NPI Number Information
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NPI Number | 1932329893
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Entity Type | Organization
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Legal Business Name | SRIVIDHYA SUBBARAYAN M D PROFESSIONAL ASSOCIATION
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 08/06/2007
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Provider Practice Location Address
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Address Line | 666 PLAINSBORO RD SUITE 2000 B
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City | PLAINSBORO
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State | NJ
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Zip | 08536-3030
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Country | US
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Telephone | 609-799-1100
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Fax | 609-799-1189
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Provider Business Mailing Address
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Address Line | 78 HARDING AVE
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City | EDISON
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State | NJ
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Zip | 08820-2524
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Country | US
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Telephone | 347-834-2592
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Fax | 732-791-2761
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. SRIVIDHYA SUBBARAYAN
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Credential | M.D.
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Telephone | 347-834-2592
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MA07067800
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License Number State | NJ
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