Provider Demographics
NPI:1558059311
Name:AVIRENI, SRUTHI SINDURA (MBBS)
Entity Type:Individual
Prefix:MS
First Name:SRUTHI
Middle Name:SINDURA
Last Name:AVIRENI
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:LINCOLN MEDICAL AND MENTAL HEALTH CENTER, DEPARTMENT OF
Mailing Address - Street 2:PEDIATRICS, 324 EAST 149TH STREET ROOM 4-20
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451
Mailing Address - Country:US
Mailing Address - Phone:718-579-5030
Mailing Address - Fax:718-579-4700
Practice Address - Street 1:LINCOLN MEDICAL AND MENTAL HEALTH CENTER, DEPARTMENT OF
Practice Address - Street 2:PEDIATRICS, 324 EAST 149TH STREET ROOM 4-20
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451
Practice Address - Country:US
Practice Address - Phone:718-579-5030
Practice Address - Fax:718-579-4700
Is Sole Proprietor?:No
Enumeration Date:2023-04-28
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program