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NPI Code Detail

MEDICARE: SRIDHAR VATTI MD

MEDICARE: SRIDHAR VATTI 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
12085R0202XDiagnostic Radiology Physician221090NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982604112
Entity Type Code : Individual
Provider Name (Legal Business Name) : SRIDHAR VATTI MD
Provider Business Mailing Address
First Line : 506 SIXTH STREET
Second Line : NEW YORK METHODIST HOSPITAL
City : BROOKLYN
State : NY
Zip : 11215
Country : US
Telephone Number : 718-780-5870
Fax Number : 718-780-7720
Provider Business Practice Location Address
First Line : 506 6TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11215-3609
Country : US
Telephone Number : 718-780-5870
Fax Number : 718-780-7720
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2005
Last Update Date : 04/12/2023

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