Healthcare Provider Details

I. General information

NPI: 1285617787
Provider Name (Legal Business Name): SHUBHIKA SRIVASTAVA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2005
Last Update Date: 05/08/2020
Certification Date: 05/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NEMOURS CARDIAC CENTER 1600 ROCKLAND ROAD
WILMINGTON DE
19803
US

IV. Provider business mailing address

PO BOX 191
ROCKLAND DE
19732-0191
US

V. Phone/Fax

Practice location:
  • Phone: 302-651-4105
  • Fax:
Mailing address:
  • Phone: 302-651-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number206814
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number206814
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberC1-0013492
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: