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Individual

DR. SRIDHAR SRINIVASAN NAMBI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
22 OLD SHORT HILLS RD, SUITE 201, LIVINGSTON, NJ 07039
(973) 535-8870
(973) 535-8818
Mailing address
22 OLD SHORT HILLS RD, SUITE 201, LIVINGSTON, NJ 07039
(973) 535-8870
(973) 535-8818

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA06771600
NJ
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
25MA06771600
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04-3694523
TAX ID
NJ
01
25MA06771600
LICENSE
NJ
01
65-1262400
TAXID
NJ
01
P00094173
RAILROAD MEDICARE PIN
NJ
Enumeration date
03/03/2006
Last updated
04/08/2024
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