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NPI Code Detail

MEDICARE: DR. SRIHARSHA DODDABALLAPUR SUBRAMANYA MD

MEDICARE: DR. SRIHARSHA DODDABALLAPUR SUBRAMANYA MD
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
1207LC0200XCritical Care Medicine (Anesthesiology) Physician48176KY
2207LC0200XCritical Care Medicine (Anesthesiology) Physician055934CT
3207L00000XAnesthesiology Physician55934CT

General Provider Information

NPI Number : 1609029602
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SRIHARSHA DODDABALLAPUR SUBRAMANYA MD
Provider Business Mailing Address
First Line : 99 EAST RIVER DRIVE
Second Line : 5TH FLOOR
City : EAST HARTFORD
State : CT
Zip : 06108-7301
Country : US
Telephone Number : 860-282-0833
Fax Number :
Provider Business Practice Location Address
First Line : 80 SEYMOUR ST
Second Line :
City : HARTFORD
State : CT
Zip : 06106-3300
Country : US
Telephone Number : 860-545-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2008
Last Update Date : 05/18/2023

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