Healthcare Provider Details

I. General information

NPI: 1598706368
Provider Name (Legal Business Name): RAJEEV D SRIVASTAVA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16215 HIGHLAND AVE
JAMAICA NY
11432-3452
US

IV. Provider business mailing address

162 15 HIGHLAND AVE SUITE A
JAMAICA NY
11432
US

V. Phone/Fax

Practice location:
  • Phone: 718-297-8398
  • Fax: 718-297-0063
Mailing address:
  • Phone: 718-297-8398
  • Fax: 718-297-0063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number197800
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: