Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Srie Widuri

Individual provider Internal Medicine Physician · NPI 1548525066

Srie Widuri is an Internal Medicine in Bronx, New York. Qualified in 2003, 23 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
23
Licensed in
NJ
In the registry since
2012
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Practice location Address checks out

1650 Grand Concourse
Bronx, NY 10457-7606
Phone: (347) 803-9707
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 25MA09740700 (NJ)

Record details

NPI number1548525066
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 10, 2012
Last updated in NPPESOctober 14, 2016
Mailing address8 Vauxhall Rd, East Brunswick, NJ 08816-1717

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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