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Individual

SANJAY KUMAR SRIVASTAVA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2422 LAKE AVE, ASHTABULA, OH 44004-4985
(440) 992-4422
Mailing address
2422 LAKE AVE, ASHTABULA, OH 44004-4985
(440) 992-4422

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
IP1065
KY
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
35.125176
OH

Other

Enumeration date
07/20/2008
Last updated
06/06/2024
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