MEDICARE: SRIRAM IYER MEDICAL, 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	207RI0011X	Interventional Cardiology Physician		NY

General Provider Information

NPI Number	:	1427450428
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SRIRAM IYER MEDICAL, PC

Provider Business Mailing Address
First Line	:	791 PARK AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10021-3551
Country	:	US
Telephone Number	:	212-290-1300
Fax Number	:	646-219-2255

Provider Business Practice Location Address
First Line	:	791 PARK AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10021-3551
Country	:	US
Telephone Number	:	212-290-1300
Fax Number	:	646-219-2255

Authorized Official
Title or Position	:	AUTHORIZED REP/OWNER
Name	:	SRIRAM S. IYER
Credential	:	MD
Telephone Number	:	212-290-1300

Provider Enumeration Date	:	09/22/2014
Last Update Date	:	12/27/2014

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