Provider Demographics
NPI:1992189583
Name:SANKARANARAYANAN, SRIRAM (MD)
Entity Type:Individual
Prefix:
First Name:SRIRAM
Middle Name:
Last Name:SANKARANARAYANAN
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 1:478 WASHINGTON AVE
Mailing Address - Street 2:#1A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-1821
Mailing Address - Country:US
Mailing Address - Phone:347-909-4023
Mailing Address - Fax:
Practice Address - Street 1:CHRISTIANA CARE HEALTH SYSTEM
Practice Address - Street 2:4755 OGLETOWN-STANTON RD, SUITE LE45
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718-0001
Practice Address - Country:US
Practice Address - Phone:302-733-1148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-14
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT209985390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program