Individual
DR. BANGALORE S SRIDHARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12 LIBERTY SQUARE MALL, STONY POINT, NY 10980-2400
(845) 942-1001
(845) 942-1431
Mailing address
20 GRAND STREET, 3RD FL, WARWICK, NY 10990-1035
(845) 942-1001
(845) 987-5979
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
213781
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000045698
GHI HMO
NY
01
—
0181480
GHI PPO
NY
05
—
01943466
—
NY
01
—
133693126
TAX ID #
NY
01
—
193679
WELLCARE
NY
01
—
213781
CONNECTICARE
NY
01
—
2386215
AETNA HMO
NY
01
—
58N891
EMPIRE BC STONY POINT
NY
01
—
58N892
EMPIRE BC WEST NYACK
NY
01
—
700608
US FAMILY HEALTH PLAN
NY
01
—
7998110
AETNA PPO
NY
01
—
961385
MVP/TACONIC IPA
NY
01
—
N67450
HEALTHNET
NY
01
—
P00114326
RAILROAD MEDICARE
NY
01
—
P1979240
OXFORD
NY
Enumeration date
01/25/2006
Last updated
01/11/2017
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