Provider Demographics
NPI:1083703680
Name:MURTHY, AMITASRIGOWRI SREENIVASA (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:AMITASRIGOWRI
Middle Name:SREENIVASA
Last Name:MURTHY
Suffix:
Gender:F
Credentials:MD, MPH
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Other - Credentials:
Mailing Address - Street 1:150 E 85TH ST
Mailing Address - Street 2:APT 10A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-2300
Mailing Address - Country:US
Mailing Address - Phone:212-452-2743
Mailing Address - Fax:
Practice Address - Street 1:462 1ST AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9196
Practice Address - Country:US
Practice Address - Phone:212-263-1404
Practice Address - Fax:212-263-8887
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY233349-1207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02284417Medicaid