Individual
DR. SRINIVAS KETHARAJU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3 LYON PL, OGDENSBURG, NY 13669-2590
(315) 713-6700
(866) 816-0815
Mailing address
330 MOUNT AUBURN ST # 2, CAMBRIDGE, MA 02138-5597
(781) 893-5550
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
1016377
MA
207V00000X
Obstetrics & Gynecology Physician
Primary
280458
NY
207V00000X
Obstetrics & Gynecology Physician
43564
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04262126
—
NY
Enumeration date
05/07/2008
Last updated
08/29/2024
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