Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 206814 | NY |
N | 2080P0202X | Pediatric Cardiologist | 206814 | NY |
Y | 2080P0202X | Pediatric Cardiologist | C1-0013492 | DE |
NPI | 1285617787 |
---|---|
Provider Name | Shubhika Srivastava |
First Address | Rockland, DE 19732-0191 |
Second Address | Wilmington, DE 19803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2005 |
Last Update Date | 08/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H83652 | (02) | NY |