Provider Demographics
NPI:1679597652
Name:KAZA, SRINIVAS R (MD)
Entity type:Individual
Prefix:MR
First Name:SRINIVAS
Middle Name:R
Last Name:KAZA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:229 PARRISH ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-1795
Mailing Address - Country:US
Mailing Address - Phone:585-394-8800
Mailing Address - Fax:585-394-5942
Practice Address - Street 1:229 PARRISH ST
Practice Address - Street 2:SUITE 250
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-1795
Practice Address - Country:US
Practice Address - Phone:585-394-8800
Practice Address - Fax:585-394-5942
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2010-03-08
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Provider Licenses
StateLicense IDTaxonomies
NY229404207Y00000X, 207YS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YS0012XAllopathic & Osteopathic PhysiciansOtolaryngologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02509364Medicaid
NY02509364Medicaid
NYRA0749Medicare PIN
H15493Medicare UPIN