Individual
ILA SRIVASTAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
6420 MERCANTILE DR E APT 108, FREDERICK, MD 21703-7613
(425) 289-6314
Mailing address
6420 MERCANTILE DR E APT 108, FREDERICK, MD 21703-7613
(425) 289-6314
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
27537
MD
Other
Enumeration date
07/30/2021
Last updated
08/23/2021
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