Individual
DR. LAKSHMI BHASKAR BIRADAVOLU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 MADISON AVE, SUITE 2B, ELMIRA, NY 14901-3218
(607) 732-1310
(607) 733-0940
Mailing address
722 W WATER ST, ELMIRA, NY 14905-2435
(607) 271-2050
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
194995
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01648219
—
NY
Enumeration date
09/17/2006
Last updated
01/30/2015
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