Provider Demographics
NPI:1669434460
Name:ATRI, SRINIVAS S (MD)
Entity type:Individual
Prefix:
First Name:SRINIVAS
Middle Name:S
Last Name:ATRI
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:ARIA HEALTH PHYSICIAN SERVICES
Mailing Address - Street 2:PO BOX 8500-6335
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-6335
Mailing Address - Country:US
Mailing Address - Phone:215-750-6566
Mailing Address - Fax:215-750-7288
Practice Address - Street 1:370 MIDDLETOWN BLVD
Practice Address - Street 2:OXFORD SQUARE STE 510
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1840
Practice Address - Country:US
Practice Address - Phone:215-750-6566
Practice Address - Fax:215-750-7288
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-05
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD030024E207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009260330012Medicaid
PA0009260330012Medicaid
PAB41746Medicare UPIN