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Organization
POONAM SRIVASTAVA MD PC
Active
Organization
POONAM SRIVASTAVA MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NAREN SRIVASTAVA (ADMINISTRATOR)
(570) 374-8555
Entity
Organization
Contact information
Practice address
1575 N OLD TRAIL, SELINSGROVE, PA 17870-1575
(570) 374-8555
(570) 374-9933
Mailing address
1575 N OLD TRAIL, SELINSGROVE, PA 17870-1575
(570) 374-8555
(570) 374-9933
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
NULL
207RH0003X
Hematology & Oncology Physician
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
PA
Other
Enumeration date
07/24/2006
Last updated
11/12/2010
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