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NPI Code Detail

MEDICARE: KHALEDA SRITI PA-C

MEDICARE: KHALEDA SRITI PA-C
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
1363A00000XPhysician AssistantOA007476PA
2363A00000XPhysician AssistantMA067159PA

General Provider Information

NPI Number : 1407716079
Entity Type Code : Individual
Provider Name (Legal Business Name) : KHALEDA SRITI PA-C
Provider Business Mailing Address
First Line : 3509 N BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19140-4105
Country : US
Telephone Number : 215-707-2433
Fax Number :
Provider Business Practice Location Address
First Line : 3401 N BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19140-5103
Country : US
Telephone Number : 800-836-7536
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2025
Last Update Date : 02/11/2026

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Directions to “ KHALEDA SRITI PA-C” Practice Location

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