Provider Demographics
NPI:1487441127
Name:KOLATHUPALAYAM SRINIVASAN, SRI DEEPA (MD)
Entity type:Individual
Prefix:
First Name:SRI DEEPA
Middle Name:
Last Name:KOLATHUPALAYAM SRINIVASAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 LEXINGTON STREET
Mailing Address - Street 2:APARTMENT 23
Mailing Address - City:AUBURNDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02466
Mailing Address - Country:US
Mailing Address - Phone:857-867-6575
Mailing Address - Fax:
Practice Address - Street 1:1901 1ST AVENUE, NYC HEALTH & HOSPITALS/METROPOLITAN
Practice Address - Street 2:MAIN BUILDING, RM 704
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-7494
Practice Address - Country:US
Practice Address - Phone:212-423-6773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program