Provider Demographics
NPI:1568610194
Name:PRADEEP, SREEDIVYA (PHD (AUDIOLOGY))
Entity Type:Individual
Prefix:DR
First Name:SREEDIVYA
Middle Name:
Last Name:PRADEEP
Suffix:
Gender:F
Credentials:PHD (AUDIOLOGY)
Other - Prefix:
Other - First Name:SREEDIVYA
Other - Middle Name:
Other - Last Name:RADHAKRISHNAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:275 N MIDDLETOWN RD STE 1G-B
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-1188
Mailing Address - Country:US
Mailing Address - Phone:845-320-5305
Mailing Address - Fax:
Practice Address - Street 1:275 N MIDDLETOWN RD
Practice Address - Street 2:STE 1G-B
Practice Address - City:PEARL RIVER
Practice Address - State:NY
Practice Address - Zip Code:10965-1188
Practice Address - Country:US
Practice Address - Phone:845-320-5305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002234231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist