Provider Demographics
NPI:1912523473
Name:SREENIVASAN, GAYATHRI (MD)
Entity Type:Individual
Prefix:DR
First Name:GAYATHRI
Middle Name:
Last Name:SREENIVASAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2646 4TH ST APT 6C
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-4932
Mailing Address - Country:US
Mailing Address - Phone:714-417-4231
Mailing Address - Fax:
Practice Address - Street 1:100 WOODS ROAD
Practice Address - Street 2:WESTCHESTER MEDICAL CENTER
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1530
Practice Address - Country:US
Practice Address - Phone:914-493-6444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-22
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program