Provider Demographics
NPI:1801100714
Name:BHADRIRAJU, SRIVIDYA (MD, MBA)
Entity type:Individual
Prefix:DR
First Name:SRIVIDYA
Middle Name:
Last Name:BHADRIRAJU
Suffix:
Gender:F
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 E 83RD ST APT 28H
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-4323
Mailing Address - Country:US
Mailing Address - Phone:512-656-8266
Mailing Address - Fax:
Practice Address - Street 1:303 E 83RD ST APT 28H
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-4323
Practice Address - Country:US
Practice Address - Phone:512-656-8266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-03
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY285491208M00000X, 207R00000X, 208000000X, 208M00000X
MA260851208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics