Individual
SRINIVAS PAVULURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 BETHANY RD STE 91, HAZLET, NJ 07730-1669
(732) 264-4300
(732) 264-1102
Mailing address
PO BOX 71, HOLMDEL, NJ 07733-0071
(732) 264-4300
(732) 264-1102
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
25MA07341500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8779805
—
NJ
Enumeration date
07/02/2006
Last updated
06/23/2022
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