| Doctor Name: | SRINIVASAN RADHAKRISHNAN |
| NPI Number: | 1487992970 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 011770-1 |
| Business Practice Address: | 63 Whitney St Closter, NJ - 076242432 |
| Business Phone Number: | 2017672424 |
| Business Fax Number: | 2027842354 |
| Mailing Address: | 63 Whitney St, CLOSTER |
| State: | NJ |
| Postal Code: | 076242432 |
| Phone Number: | 2017672424 |
| Fax Number: | 2027842354 |
| NPI Enumeration Date: | 01/18/2013 |
| NPI Last Update Date: | 01/18/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 011770-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |