Individual
AMANDA ANN SRINIVASAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
510 JACKSON AVE, NORTHFIELD, NJ 08225-1631
(609) 383-0200
(609) 383-8352
Mailing address
104 24TH ST S, BRIGANTINE, NJ 08203-1834
(570) 401-8016
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
25MP00615000
NJ
Other
Enumeration date
04/20/2021
Last updated
05/05/2021
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