Provider Demographics
NPI:1104407675
Name:SRISETHNIL, ISRIN (DO)
Entity type:Individual
Prefix:DR
First Name:ISRIN
Middle Name:
Last Name:SRISETHNIL
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1945 CORLIES AVE
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-5197
Mailing Address - Country:US
Mailing Address - Phone:732-897-0200
Mailing Address - Fax:732-897-0263
Practice Address - Street 1:1945 CORLIES AVE
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-5197
Practice Address - Country:US
Practice Address - Phone:732-897-0200
Practice Address - Fax:732-897-0263
Is Sole Proprietor?:No
Enumeration Date:2021-04-16
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB12614700207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology