| Pudchong Srisethnil, Md, Pa | |
|
561 E 28th St Paterson NJ 07504-1862 | |
| (973) 278-4673 | |
| (973) 278-0450 |
| Full Name | Pudchong Srisethnil, Md, Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 561 E 28th St, Paterson, New Jersey |
| Authorized Official Name and Position | Pudchong Srisethnil (PRESIDENT/PHYSICIAN) |
| Authorized Official Contact | 9732784673 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pudchong Srisethnil, Md, Pa 561 E 28th St Paterson NJ 07504-1862 Ph: (973) 278-4673 | Pudchong Srisethnil, Md, Pa 561 E 28th St Paterson NJ 07504-1862 Ph: (973) 278-4673 |
| NPI Number | 1952744872 |
|---|---|
| Provider Enumeration Date | 04/10/2013 |
| Last Update Date | 04/10/2013 |
| Medicare PECOS PAC ID | 9032356761 |
|---|---|
| Medicare Enrollment ID | O20130516000292 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952744872 | NPI | - | NPPES |
| Provider Name | Pudchong Srisethnil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770690315 PECOS PAC ID: 0244262681 Enrollment ID: I20050907000034 |
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