Organization
SRINIVAS PAVULURI, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SRINIVAS PAVULURI MD (OWNER)
(732) 264-4301
Entity
Organization
Contact information
Practice address
668 N BEERS ST, SUITE 101, HOLMDEL, NJ 07733-1526
(732) 264-4301
(732) 264-1102
Mailing address
PO BOX 71, HOLMDEL, NJ 07733-0071
(732) 264-4301
(732) 264-1102
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
25MA07341500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056224U33
MEDICARE PTAN#
—
Enumeration date
07/22/2006
Last updated
03/19/2014
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