Provider Demographics
NPI:1538369418
Name:AMARA, SREENIVASRAO (MD)
Entity type:Individual
Prefix:DR
First Name:SREENIVASRAO
Middle Name:
Last Name:AMARA
Suffix:
Gender:M
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:B2 CORNWALL DR
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3352
Mailing Address - Country:US
Mailing Address - Phone:732-257-4008
Mailing Address - Fax:732-257-1958
Practice Address - Street 1:B2 CORNWALL DR
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3352
Practice Address - Country:US
Practice Address - Phone:732-257-4008
Practice Address - Fax:732-257-1958
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236569207K00000X
NJ25MA08217500207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6N6381OtherEMPIRE BC
NJ0232955Medicaid
NJ01004808200OtherAMERICHOICE
NJ1293197OtherG.H.I.
NJ2050340OtherCOVENTRY HEALTH/FIRST HEALTH
NJP4061407OtherOXFORD HEALTH PLAN
NJ01307948OtherAMERIGROUP
NJ1522135OtherCIGNA
NJ1538269418OtherU.S.FAMILY HEALTH
NJ6060012OtherAETNA
NJ9376056OtherAETNA
NJ60075061OtherHORIZON N.J. HEALTH
NJP4061407OtherOXFORD HEALTH PLAN