Pudchong Srisethnil (NPI# 1770690315, PAC ID# 0244262681) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1770690315 |
| PAC ID by PECOS | 0244262681 |
| Professional Enrollment ID | I20050907000034 |
| Full Name | Pudchong Srisethnil |
| Address |
561 E 28th St Paterson NJ 07504-1862 |
| Gender | M |
| Credential | MD |
| Graduation Year | 1972 |
| Primary Specialty | INTERNAL MEDICINE |
| Secondary Specialties | ENDOCRINOLOGY |
| Accepts Medicare Assignment | M |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 310019 | ST JOSEPH'S HOSPITAL AND MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 561 E 28th St, Paterson, NJ 07504-1862 |
| Street Address |
561 E 28TH ST |
| City | PATERSON |
| State | NJ |
| Zip | 07504-1862 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Scott A Goler | Podiatry | Sovereign Medical Group LLC | 265 E 33rd St, Paterson, NJ 07504-1668 |
| Daniel J Waltuch | Podiatry | Sovereign Medical Group LLC | 265 E 33rd St, Paterson, NJ 07504-1668 |
| Alvaro Tellez | Internal Medicine | 466 Park Ave, Paterson, NJ 07504-1806 | |
| Fred Revoredo | General Practice | 425 15th Ave, Suite 2, Paterson, NJ 07504-1811 | |
| Nidia Ortega | Family Medicine | Centro Medico Iberoamericano Inc. | 416 Park Ave, Paterson, NJ 07504-1930 |
| Melissa Amy Desueza | Nurse Practitioner | Centro Medico Iberoamericano Inc. | 416 Park Ave, Paterson, NJ 07504-1930 |
| Ramon A Sandoval | Internal Medicine | Centro Medico Iberoamericano Inc. | 416 Park Ave, Paterson, NJ 07504-1930 |
| Juan A Desueza | Internal Medicine | Centro Medico Iberoamericano Inc. | 416 Park Ave, Paterson, NJ 07504-1930 |
| City | PATERSON |
| Zip Code | 07504 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | PATERSON + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Pudchong Srisethnil.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.