Provider Demographics
NPI:1346215225
Name:ESWARAPU, SRINIVASA (MD)
Entity Type:Individual
Prefix:DR
First Name:SRINIVASA
Middle Name:
Last Name:ESWARAPU
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 1:35 CALVERT AVE E
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-3251
Mailing Address - Country:US
Mailing Address - Phone:973-450-9600
Mailing Address - Fax:973-450-4054
Practice Address - Street 1:252 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-3155
Practice Address - Country:US
Practice Address - Phone:973-450-9600
Practice Address - Fax:973-450-4054
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA68009207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8044104Medicaid
H12970Medicare UPIN
NJ8044104Medicaid