Organization
PEDIATRIC HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SRINIVAS P THANDLA M.D. (SOLE PROPRIETOR)
(716) 945-0368
Entity
Organization
Contact information
Practice address
4039 RTE 219 SUITE 103, SALAMANCA, NY 14779-9625
(716) 945-0368
(716) 945-0757
Mailing address
4039 RTE 219 SUITE 103, SALAMANCA, NY 14779-9625
(716) 945-0368
(716) 945-0757
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
237701
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02056637
—
NY
Enumeration date
05/03/2007
Last updated
07/24/2008
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