Provider Demographics
NPI:1033523592
Name:PAIDAKULA, SRIHARI (MD)
Entity Type:Individual
Prefix:DR
First Name:SRIHARI
Middle Name:
Last Name:PAIDAKULA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 OLD SHERMAN TPKE
Mailing Address - Street 2:SUITE 212
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-4174
Mailing Address - Country:US
Mailing Address - Phone:203-743-9760
Mailing Address - Fax:203-743-3411
Practice Address - Street 1:130 DIVISION ST
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:CT
Practice Address - Zip Code:06418-1326
Practice Address - Country:US
Practice Address - Phone:203-743-9760
Practice Address - Fax:203-743-3411
Is Sole Proprietor?:No
Enumeration Date:2014-06-12
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program