Provider Demographics
NPI:1356370266
Name:NARSIPUR, SRIRAM S (MD)
Entity type:Individual
Prefix:
First Name:SRIRAM
Middle Name:S
Last Name:NARSIPUR
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Gender:M
Credentials:MD
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Mailing Address - Street 1:90 PRESIDENTIAL PLZ
Mailing Address - Street 2:FIRM C
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202-2240
Mailing Address - Country:US
Mailing Address - Phone:315-464-3834
Mailing Address - Fax:315-464-3837
Practice Address - Street 1:90 PRESIDENTIAL PLZ
Practice Address - Street 2:FIRM C
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-2240
Practice Address - Country:US
Practice Address - Phone:315-464-3834
Practice Address - Fax:315-464-3837
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2010-10-20
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Provider Licenses
StateLicense IDTaxonomies
NY2032282080P0210X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01657345Medicaid
NYP110124461Medicare PIN
NY01657345Medicaid