Organization
DEEPAK SRINIVASAN, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEEPAK SRINIVASAN M.D. (PRESIDENT)
(201) 312-7682
Entity
Organization
Contact information
Practice address
11-10 5TH ST, FAIR LAWN, NJ 07410-1473
(201) 312-7682
Mailing address
11-10 5TH ST, FAIR LAWN, NJ 07410-1473
(201) 312-7682
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MA06740000
NJ
207RI0011X
Interventional Cardiology Physician
MA06740000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018180
—
NJ
Enumeration date
05/18/2009
Last updated
05/18/2009
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