Pudchong Srisethnil, MD, PA

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

Legal business name

PUDCHONG SRISETHNIL, MD, PA

Practice address

561 E 28TH St
Paterson, NJ 07504-1862

Phone

(973) 278-4673

Fax

(973) 278-0450

NPI assigned

Apr 10, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Pudchong Srisethnil, MD

Title

President/Physician

Phone

(973) 278-4673

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jodi Michele Welt, MS, RD, PA

  • Physician Assistant
  • Paterson, NJ
  • NPI 1689801284
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1365552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365552000000",
    "number": "1952744872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "561 E 28TH ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075041862",
            "telephone_number": "973-278-4673",
            "fax_number": "973-278-0450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "561 E 28TH ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075041862",
            "telephone_number": "973-278-4673",
            "fax_number": "973-278-0450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUDCHONG SRISETHNIL, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-10",
        "last_updated": "2013-04-10",
        "status": "A",
        "authorized_official_last_name": "SRISETHNIL",
        "authorized_official_first_name": "PUDCHONG",
        "authorized_official_title_or_position": "PRESIDENT/PHYSICIAN",
        "authorized_official_telephone_number": "973-278-4673",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NJ",
            "license": "MA30779",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Proventus Healthcare P.C.
• James Pruden, MD
• John G Psomas
• Nicholas G. Psomas, RPH
• Zarah Jane Pua, M.D.
• Jaime L. Pula, PHD, RD
• Pure Kinetics
• Pure One Wellness Center, LLC
• Adil Suresh Puthileth, PHARMD
• Sohail Qayyum, MD

• Endocrinology, Diabetes & Metabolism Physician in Paterson, NJ
• Providers in Paterson, NJ by specialty
• Endocrinology, Diabetes & Metabolism Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.