Individual
DR. SRINIVASA SARVABHOUMA THOTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
(315) 464-4720
Mailing address
5784 WIDEWATERS PKWY STE 2, SYRACUSE, NY 13214-1890
(315) 469-1130
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01084118A
IN
207L00000X
Anesthesiology Physician
268939
NY
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
268939
NY
208VP0014X
Interventional Pain Medicine Physician
01084118A
IN
208VP0014X
Interventional Pain Medicine Physician
TP370
KY
Other
Enumeration date
04/23/2009
Last updated
08/22/2024
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