Organization
PRATIBHA SRINIVASAN
Active
Other names
SMART EARS
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PRATIBHA SRINIVASAN (SOLE PROPRIETOR AND AUDIOLOGIST)
(804) 399-4066
Entity
Organization
Contact information
Practice address
220 S WASHINGTON ST, #203, ALEXANDRIA, VA 22314-3626
(804) 399-4066
(703) 891-9854
Mailing address
1019 DAWNWOOD RD, MIDLOTHIAN, VA 23114-4489
(804) 399-4066
(703) 891-9854
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
2201000379
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
352434
ANTHEM
VA
05
—
9450025
—
VA
01
—
M986
CAREFIRST BCBS
VA
Enumeration date
07/20/2010
Last updated
07/20/2010
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