Basic Information
Provider Information
NPI: 1033367859
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ELURI
FirstName: LAKSHMI SIREESHA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2 CATHARINE ST
Address2: P.O. BOX 550
City: POUGHKEEPSIE
State: NY
PostalCode: 126013100
CountryCode: US
TelephoneNumber: 8668688416
FaxNumber: 8457902675
Practice Location
Address1: 506 6TH ST
Address2: NY METHODIST HOSPITAL
City: BROOKLYN
State: NY
PostalCode: 112153609
CountryCode: US
TelephoneNumber: 7187803279
FaxNumber: 7187803281
Other Information
ProviderEnumerationDate: 09/04/2008
LastUpdateDate: 10/06/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X250224NYY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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