Healthcare Provider Details

I. General information

NPI: 1912576877
Provider Name (Legal Business Name): APURVA SRIVASTAV DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2021
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 MADISON AVE RM 200
NEW YORK NY
10017-1119
US

IV. Provider business mailing address

425 MADISON AVE RM 200
NEW YORK NY
10017-1119
US

V. Phone/Fax

Practice location:
  • Phone: 212-257-0701
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberOS023269
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number346290
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: