Healthcare Provider Details

I. General information

NPI: 1518935451
Provider Name (Legal Business Name): GEETANJALI SRIVASTAVA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MICHIGAN AVE NW CHILDREN'S NATIONAL MEDICAL CENTER
WASHINGTON DC
20010-2978
US

IV. Provider business mailing address

304 E DUNCAN AVE APT #G
ALEXANDRIA VA
22301-1290
US

V. Phone/Fax

Practice location:
  • Phone: 202-884-4177
  • Fax:
Mailing address:
  • Phone: 917-519-8782
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD423367
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberD0064061
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberMD035923
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: