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Organization

ON-SITE MEDICAL PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RAJEEV D SRIVASTAVA MD (OWNER)
(718) 907-1091
Entity
Organization

Contact information

Practice address
29-28 DITMARS BOULEVARD, ASTORIA, NY 11105-2731
(718) 907-1091
Mailing address
162-15 HIGHLAND AVENUE, SUITE 1A, JAMAICA, NY 11432
(718) 907-1091

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
2085U0001X
Diagnostic Ultrasound Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03538290
NY
Enumeration date
09/14/2012
Last updated
05/10/2013
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