Individual ProviderSrilakshmi MittaInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address1 Gustave L Levy Pl, Box 1110, New York, NY 10029-6500(212) 659-8553(401) 453-7950PECOS EnrollmentBased on the most recent information from CMS, provider Srilakshmi Mitta is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1083829774Provider TypeIndividualFull NameMitta, SrilakshmiTitleDr.CredentialM.D.GenderFemaleSole ProprietorYesEnumeration Date5/14/2007Last Updated11/13/2014Contact InformationPractice LocationPractice Address1 Gustave L Levy Pl, Box 1110, New York, NY 10029-6500Phone(212) 659-8553FaxUnlisted FaxMailing LocationMailing Address100 Dudley St, 3rd Floor, Providence, RI 02905-3233Phone(401) 453-7950FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense13002Rhode IslandCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense240627New YorkCode208000000XDescriptionPediatricsAllopathic & Osteopathic PhysiciansLicense240627New York