Provider Demographics
NPI:1588828917
Name:JOSHI, SREENATH R (MD)
Entity type:Individual
Prefix:DR
First Name:SREENATH
Middle Name:R
Last Name:JOSHI
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 1:618 CORNWALL RD
Mailing Address - Street 2:WELLSPAN GOOD SAMARITAN PEDIATRICS
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-7089
Mailing Address - Country:US
Mailing Address - Phone:717-279-6700
Mailing Address - Fax:
Practice Address - Street 1:618 CORNWALL RD
Practice Address - Street 2:WELLSPAN GOOD SAMARITAN PEDIATRICS
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7089
Practice Address - Country:US
Practice Address - Phone:717-279-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD453344208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics