Individual
DR. MANISHA RAGHAVAN SRINIVASA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1200 OLD YORK RD STE 2B, ABINGTON, PA 19001-3720
(215) 481-2222
Mailing address
2500 MARYLAND RD STE 400, WILLOW GROVE, PA 19090-1225
(215) 481-4143
(215) 481-4143
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
81391
GA
207R00000X
Internal Medicine Physician
Primary
MD455622
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
455622
LICENSE NUMBER
PA
01
—
81391
LICENSE NUMBER
GA
Enumeration date
06/27/2012
Last updated
10/23/2018
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