Individual
MR. CHINAGANDHAM SRINIVISA BHUPATHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11 RALPH PL, SUITE 102, STATEN ISLAND, NY 10304-4419
(718) 447-6545
(718) 447-5297
Mailing address
11 RALPH PL, SUITE 102, STATEN ISLAND, NY 10304-4419
(718) 447-6545
(718) 447-5297
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
116509
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00215816
—
NY
Enumeration date
09/08/2005
Last updated
07/08/2007
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