# PUDCHONG SRISETHNIL, MD, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952744872
- **Authorized official:** DR. PUDCHONG SRISETHNIL MD (PRESIDENT/PHYSICIAN)
- **Authorized official phone:** (973) 278-4673

## Contact information

- **Practice address:** 561 E 28TH ST, PATERSON, NJ 07504-1862
- **Practice address phone:** (973) 278-4673
- **Practice address fax:** (973) 278-0450
- **Mailing address:** 561 E 28TH ST, PATERSON, NJ 07504-1862
- **Mailing address phone:** (973) 278-4673
- **Mailing address fax:** (973) 278-0450

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | MA30779 | NJ | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | Yes |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/10/2013
- **Last updated:** 04/10/2013