Individual ProviderLakshmi SridharanStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address630 W. 168th St, Box 93, Ph 10-203 Columbia Univ, College Of P&S,, New York, NY 10032(212) 342-1371PECOS EnrollmentBased on the most recent information from CMS, provider Lakshmi Sridharan is legally eligible to order and refer claims for Part B, HHA and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1376834408Provider TypeIndividualFull NameSridharan, LakshmiCredentialM.D.GenderFemaleSole ProprietorNoEnumeration Date4/24/2011Last Updated7/1/2019Contact InformationPractice LocationPractice Address630 W. 168th St, Box 93, Ph 10-203 Columbia Univ, College Of P&S,, New York, NY 10032Phone(212) 342-1371FaxUnlisted FaxMailing LocationMailing Address630 West 168th Street, Box 93, Ph 10-203 Columbia Univ, College Of P&S, New York, NY 10032PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted IssuerCode207RA0001XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense82893Georgia