Ketharaju, Srinivas

Ketharaju, Srinivas is an individual health care provider with primary practice located at 3 Lyon Pl , Ogdensburg NY 13669-2590. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Ketharaju, Srinivas can be contacted via phone (315) 713-6700.

Contact Information

Primary practice address
3 Lyon Pl Ogdensburg NY 13669-2590
Phone: (315) 713-6700
Fax: (866) 816-0815
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 43564 Kentucky
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 1016377 Massachusetts
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 280458 New York

Profile Details

NPI number 1346416559
LBN Legal business name Ketharaju, Srinivas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 7th, 2008
Last updated Aug 29th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346416559 NPPES
New York MEDICAID 04262126

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