MEDICARE: DR. SRIRAMANI SIVAPURAPU PHARMD

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	183500000X	Pharmacist	PCT.0016898	CT

General Provider Information

NPI Number	:	1912890294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SRIRAMANI SIVAPURAPU PHARMD

Provider Business Mailing Address
First Line	:	254 PENWOOD XING
Second Line	:
City	:	GLASTONBURY
State	:	CT
Zip	:	06033-2760
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	972 SILVER LN
Second Line	:
City	:	EAST HARTFORD
State	:	CT
Zip	:	06118-1248
Country	:	US
Telephone Number	:	860-568-0888
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2025
Last Update Date	:	06/03/2025

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