Basic Information
| Provider Information | |||||||||
| NPI: | 1699180646 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SIRASATI | ||||||||
| FirstName: | UDAYAKIRAN | ||||||||
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| Credential: | M.D., | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2150 PENSYLVANIA AVENUE NW, 6B-402 | ||||||||
| Address2: | MEDICAL FACULTY ASSOCIATES C/O ROBERT PAKAN | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200373201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2027413157 | ||||||||
| FaxNumber: | 2027413285 | ||||||||
| Practice Location | |||||||||
| Address1: | 900 23RD ST NW | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200372342 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2027154000 | ||||||||
| FaxNumber: | 2027413285 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2014 | ||||||||
| LastUpdateDate: | 07/17/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | TRN20438 | FL | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 390200000X | MTL003337 | DC | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.