Provider Demographics
NPI:1023128832
Name:SRINIVASAN, SUBRAMANIAM (MD)
Entity type:Individual
Prefix:
First Name:SUBRAMANIAM
Middle Name:
Last Name:SRINIVASAN
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 1:2401 E STREET NW
Mailing Address - Street 2:U.S.DEPT.OF STATE,M/MED/QI,SA-1
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20522-0001
Mailing Address - Country:US
Mailing Address - Phone:202-663-1662
Mailing Address - Fax:202-663-3673
Practice Address - Street 1:2401 E STREET NW
Practice Address - Street 2:U.S.DEPT.OF STATE,M/MED/QI,SA-1
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20522-0001
Practice Address - Country:US
Practice Address - Phone:202-663-1662
Practice Address - Fax:202-663-3673
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY130861207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease