Individual
KAVITHA SRINIVASAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
41 BREWSTER RD, INTERNAL MEDICINE, BRISTOL, CT 06010-5161
(860) 585-3500
Mailing address
200 BLAKESLEE ST APT 85, BRISTOL, CT 06010-6399
(347) 387-6278
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
048627
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/29/2007
Last updated
06/30/2010
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