Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 35120267 | OH |
NPI | 1275767030 |
---|---|
Provider Name | Dr. Puja Kesari Srivastava |
First Address | Cincinnati, OH 45212-3359 |
Second Address | Cincinnati, OH 45220-2475 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2009 |
Last Update Date | 13/06/2016 |