Provider Demographics
NPI:1174656011
Name:CHANDRASEKHAR, SREEDEVI TN (MD)
Entity Type:Individual
Prefix:DR
First Name:SREEDEVI
Middle Name:TN
Last Name:CHANDRASEKHAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 1ST AVE APT 6B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3786
Mailing Address - Country:US
Mailing Address - Phone:212-725-7277
Mailing Address - Fax:212-448-0727
Practice Address - Street 1:630 1ST AVE APT 6B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3786
Practice Address - Country:US
Practice Address - Phone:212-725-7277
Practice Address - Fax:212-448-0727
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY108311207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine