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General NPI Number Information
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NPI Number | 1952626277
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Entity Type | Individual
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Provider Name | DR. TARA SREEDHARAN
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Gender | Female
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Dates
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Enumeration Date | 03/30/2010
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Last Update Date | 03/30/2010
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Provider Practice Location Address
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Address Line | 27 PHEASANT RUN
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City | SCARSDALE
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State | NY
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Zip | 10583-3100
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Country | US
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Telephone | 914-723-5110
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Fax |
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Provider Business Mailing Address
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Address Line | 27 PHEASANT RUN
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City | SCARSDALE
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State | NY
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Zip | 10583
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Country | US
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Telephone | 914-723-5110
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Fax |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 130471
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License Number State | NY
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