Provider Demographics
NPI:1952192569
Name:SRINIVASAN, ADRIANA
Entity type:Individual
Prefix:
First Name:ADRIANA
Middle Name:
Last Name:SRINIVASAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1512 EASTON AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-1367
Mailing Address - Country:US
Mailing Address - Phone:617-416-6082
Mailing Address - Fax:
Practice Address - Street 1:1512 EASTON AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-1367
Practice Address - Country:US
Practice Address - Phone:617-416-6082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA016094171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter