Provider Demographics
NPI:1396069092
Name:SIRCAR, PADMINI (MD)
Entity type:Individual
Prefix:
First Name:PADMINI
Middle Name:
Last Name:SIRCAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 N BROAD STREET EXT
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16127-5805
Mailing Address - Country:US
Mailing Address - Phone:724-458-5150
Mailing Address - Fax:724-458-0735
Practice Address - Street 1:675 N BROAD STREET EXT
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:PA
Practice Address - Zip Code:16127-5805
Practice Address - Country:US
Practice Address - Phone:724-458-5150
Practice Address - Fax:724-458-0735
Is Sole Proprietor?:No
Enumeration Date:2010-03-24
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY256503207RC0000X
PAMD440741207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3099641Medicaid
WV3810018147Medicaid
PA1024897800001Medicaid
PA188541NJ5Medicare PIN
WV3810018147Medicaid