| Srivani Srikantiah, M.d. Pllc | |
|
18275 N 59th Ave Suite 138 Glendale AZ 85308-1260 | |
| (602) 564-0078 | |
| (602) 564-2719 |
| Full Name | Srivani Srikantiah, M.d. Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 18275 N 59th Ave, Glendale, Arizona |
| Authorized Official Name and Position | Deanna S Jarrett (OFFICE ADMINISTRATOR) |
| Authorized Official Contact | 6025640078 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Srivani Srikantiah, M.d. Pllc 18275 N 59th Ave Suite 138 Glendale AZ 85308-1260 Ph: (602) 564-0078 | Srivani Srikantiah, M.d. Pllc 18275 N 59th Ave Suite 138 Glendale AZ 85308-1260 Ph: (602) 564-0078 |
| NPI Number | 1669730628 |
|---|---|
| Provider Enumeration Date | 04/27/2012 |
| Last Update Date | 04/27/2012 |
| Medicare PECOS PAC ID | 7911160239 |
|---|---|
| Medicare Enrollment ID | O20120524000528 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669730628 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 34435 (Arizona) | Primary |
| Provider Name | Srivani K Srikantiah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255467270 PECOS PAC ID: 7416030739 Enrollment ID: I20080211000235 |
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