MEDICARE: HARI GNANASEKERAM, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246W00000X	Cardiology Technician

General Provider Information

NPI Number	:	1255871893
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARI GNANASEKERAM, PC

Provider Business Mailing Address
First Line	:	2601 BELMAR BLVD
Second Line	:
City	:	WALL
State	:	NJ
Zip	:	07719-4167
Country	:	US
Telephone Number	:	732-280-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	5418 N LOOP 1604 W
Second Line	:	3RD FLOOR
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-4558
Country	:	US
Telephone Number	:	732-280-6000
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	THOMAS CORNEY
Credential	:
Telephone Number	:	732-280-6000

Provider Enumeration Date	:	03/01/2017
Last Update Date	:	03/01/2017

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