| Srinivas Pavuluri, Md, Pa | |
|
668 N Beers St Suite 101 Holmdel NJ 07733-1526 | |
| (732) 264-4301 | |
| (732) 264-1102 |
| Full Name | Srinivas Pavuluri, Md, Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 668 N Beers St, Holmdel, New Jersey |
| Authorized Official Name and Position | Srinivas Pavuluri (OWNER) |
| Authorized Official Contact | 7322644301 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Srinivas Pavuluri, Md, Pa Po Box 71 Holmdel NJ 07733-0071 Ph: (732) 264-4301 | Srinivas Pavuluri, Md, Pa 668 N Beers St Suite 101 Holmdel NJ 07733-1526 Ph: (732) 264-4301 |
| NPI Number | 1639190705 |
|---|---|
| Provider Enumeration Date | 07/22/2006 |
| Last Update Date | 03/19/2014 |
| Medicare PECOS PAC ID | 4789690447 |
|---|---|
| Medicare Enrollment ID | O20060306000002 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639190705 | NPI | - | NPPES |
| 056224U33 | Other | MEDICARE PTAN# |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 25MA07341500 (New Jersey) | Primary |
| Provider Name | Srinivas Pavuluri |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1255360020 PECOS PAC ID: 0244127066 Enrollment ID: I20040304000347 |
| Provider Name | Edgar Y Chen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871569616 PECOS PAC ID: 0547333783 Enrollment ID: I20100510000631 |
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