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Individual

DR. PUDCHONG S SRISETHNIL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D., F.A.C.E.

Contact information

Practice address
561 E 28TH ST, PATERSON, NJ 07504-1825
(973) 278-4673
(973) 278-0450
Mailing address
561 E 28TH ST, PATERSON, NJ 07504-1825
(973) 278-4673
(973) 278-0450

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
MA30779
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
222385269
TAX ID
NJ
01
MA30779
LICENSE #
NJ
Enumeration date
08/23/2006
Last updated
03/07/2023
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