1518935451 NPI number — DR. GEETANJALI SRIVASTAVA MD

Table of content: DR. GEETANJALI SRIVASTAVA MD (NPI 1518935451)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518935451 NPI number — DR. GEETANJALI SRIVASTAVA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SRIVASTAVA
Provider First Name:
GEETANJALI
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518935451
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
304 E DUNCAN AVE
Provider Second Line Business Mailing Address:
APT #G
Provider Business Mailing Address City Name:
ALEXANDRIA
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22301-1290
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
917-519-8782
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
111 MICHIGAN AVE NW
Provider Second Line Business Practice Location Address:
CHILDREN'S NATIONAL MEDICAL CENTER
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20010-2978
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-884-4177
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/08/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  MD423367 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 2080P0204X , with the licence number: D0064061 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 2080P0204X , with the licence number: MD035923 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1567634 . This is a "HIGHMARK BS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1008669760001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2248294000 . This is a "INDEPENDENCE BC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".