Provider Demographics
NPI:1285022087
Name:LOKASUBRAMANIAN, SRIDEVI (MD)
Entity Type:Individual
Prefix:DR
First Name:SRIDEVI
Middle Name:
Last Name:LOKASUBRAMANIAN
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 1:178-10 WEXFORD TERRACE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA ESTATES
Mailing Address - State:NY
Mailing Address - Zip Code:11432
Mailing Address - Country:US
Mailing Address - Phone:718-658-1123
Mailing Address - Fax:
Practice Address - Street 1:178-10 WEXFORD TERRACE
Practice Address - Street 2:
Practice Address - City:JAMAICA ESTATES
Practice Address - State:NY
Practice Address - Zip Code:11432
Practice Address - Country:US
Practice Address - Phone:718-658-1123
Practice Address - Fax:718-658-7091
Is Sole Proprietor?:No
Enumeration Date:2014-12-31
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2820022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry