Provider Demographics
NPI:1841487923
Name:SR MEDICAL CENTER LLC
Entity type:Organization
Organization Name:SR MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:SARITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:REGULAPATI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-274-2557
Mailing Address - Street 1:462 NEW RD
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08852-2653
Mailing Address - Country:US
Mailing Address - Phone:732-274-2557
Mailing Address - Fax:732-274-6777
Practice Address - Street 1:462 NEW RD
Practice Address - Street 2:
Practice Address - City:MONMOUTH JUNCTION
Practice Address - State:NJ
Practice Address - Zip Code:08852-2653
Practice Address - Country:US
Practice Address - Phone:732-274-2557
Practice Address - Fax:732-274-6777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-02
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ126663Medicare PIN
NJI48670Medicare UPIN