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Individual

SURIYA SRIDARAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT

Contact information

Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 334-3278
(508) 334-7284
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA100887
MA
363AM0700X
Medical Physician Assistant
363AS0400X
Surgical Physician Assistant

Other

Enumeration date
06/24/2024
Last updated
08/27/2024
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