Provider Demographics
NPI:1033268602
Name:SRIHARI, VINOD H (MD)
Entity Type:Individual
Prefix:DR
First Name:VINOD
Middle Name:H
Last Name:SRIHARI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:34 PARK ST CONNECTICUT MENTAL HEALTH CENTER
Mailing Address - Street 2:OFFICE OF CARE MANAGEMENT
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519
Mailing Address - Country:US
Mailing Address - Phone:203-974-7417
Mailing Address - Fax:203-974-7413
Practice Address - Street 1:34 PARK ST
Practice Address - Street 2:CONNECTICUT MENTAL HEALTH CENTER
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519
Practice Address - Country:US
Practice Address - Phone:203-974-7417
Practice Address - Fax:203-974-7413
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT0401512084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
I38019Medicare UPIN