Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 227592 | MA |
N | 207N00000X | Dermatologist | 230026 | NY |
N | 207ND0101X | MOHS-Micrographic Surgeon | 25MA083600800 | NJ |
Y | 207ND0101X | MOHS-Micrographic Surgeon | ME101443 | FL |
NPI | 1437117058 |
---|---|
Provider Name | Monika Srivastava |
First Address | Vero Beach, FL 32960-4875 |
Second Address | Vero Beach, FL 32960 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 20/08/2018 |