Provider Demographics
NPI:1750305835
Name:MADANE, SRINIVAS JANARDHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SRINIVAS
Middle Name:JANARDHAN
Last Name:MADANE
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 1:33 RIDGELINE DR
Mailing Address - Street 2:
Mailing Address - City:LONG VALLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07853-3376
Mailing Address - Country:US
Mailing Address - Phone:732-739-4400
Mailing Address - Fax:732-739-8809
Practice Address - Street 1:222 HIGH STREET STE 102
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-9604
Practice Address - Country:US
Practice Address - Phone:973-579-5090
Practice Address - Fax:973-579-7409
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07289400207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0096041Medicaid
NJ052021N1WMedicare PIN
NJH50523Medicare UPIN