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Organization

SRI GASTROENTEROLOGY PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SRIDEVI BHUMI MD (PHYSICIAN)
(718) 416-4389
Entity
Organization

Contact information

Practice address
901 STEWART AVE, GARDEN CITY, NY 11530-4893
(516) 222-2727
(718) 416-3652
Mailing address
8 QUAKER LN, OLD WESTBURY, NY 11568-1320
(718) 416-4389
(718) 416-3652

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A1000075759
MEDICARE PTAN
NY
01
A400075761
MEDICARE PTAN OTHER
NY
Enumeration date
07/11/2012
Last updated
01/10/2014
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