| Dr Patalam Sriramulu Sriharsha, MD | |
|
750 E Broad St, Hazleton, PA 18201-6835 | |
| (570) 455-6385 | |
| (570) 455-7064 |
| Full Name | Dr Patalam Sriramulu Sriharsha |
|---|---|
| Gender | Male |
| Speciality | Psychiatry & Neurology - Geriatric Psychiatry |
| Location | 750 E Broad St, Hazleton, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154377562 | NPI | - | NPPES |
| 0008345120004 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | MD025995E (Pennsylvania) | Primary |
| Entity Name | Northeast Counseling Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649608530 PECOS PAC ID: 5799768115 Enrollment ID: O20040608000843 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Patalam Sriramulu Sriharsha, MD 750 E Broad St, Hazleton, PA 18201-6835 Ph: (570) 455-6385 | Dr Patalam Sriramulu Sriharsha, MD 750 E Broad St, Hazleton, PA 18201-6835 Ph: (570) 455-6385 |
Shu-guang Xu, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 50 Moisey Drive, Suite 210, Hazleton, PA 18202 Phone: 484-884-3333 | |
Ajit M Chikarmane, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 20 N Laurel St, Suite 2b, Hazleton, PA 18201 Phone: 570-454-5715 Fax: 570-455-5095 | |
Mrs. Susan Joann Garrett, RN, BSN Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 750 E Broad St, Hazleton, PA 18201 Phone: 570-455-6385 Fax: 570-579-0355 |