Individual
VANITA SRIVASTAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
327 BEACH 19TH ST, FAR ROCKAWAY, NY 11691-4423
(718) 869-7108
Mailing address
327 BEACH 19TH ST, FAR ROCKAWAY, NY 11691-4423
(718) 869-7108
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
280641
NY
Other
Enumeration date
02/06/2014
Last updated
04/17/2017
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