| Doctor Name: | KAVITHA SRINIVASAN |
| NPI Number: | 1104010503 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D |
| License Number: | |
| Business Practice Address: | 41 Brewster Rd Internal Medicine Bristol, CT - 060105161 |
| Business Phone Number: | 8605853500 |
| Business Fax Number: | |
| Mailing Address: | 200 Blakeslee St Apt 85, BRISTOL |
| State: | CT |
| Postal Code: | 060106399 |
| Phone Number: | 3473876278 |
| Fax Number: | |
| NPI Enumeration Date: | 08/29/2007 |
| NPI Last Update Date: | 06/30/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |