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General NPI Number Information
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NPI Number | 1255645859
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Entity Type | Organization
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Legal Business Name | SHASHANK C. SRIVASTAVA,DPM,LLC
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Dates
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Enumeration Date | 08/06/2010
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Last Update Date | 11/08/2010
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Provider Practice Location Address
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Address Line | 3301 NEW MEXICO AVENUE NW SUITE 221
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City | WASHINGTON
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State | DC
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Zip | 20016-3610
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Country | US
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Telephone | 202-237-0038
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Fax | 202-237-2551
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Provider Business Mailing Address
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Address Line | 2401 RESEARCH BLVD SUITE 350
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City | ROCKVILLE
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State | MD
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Zip | 20850-3215
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Country | US
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Telephone | 301-330-0468
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Fax | 301-330-3489
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Authorized Official
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Title or Position | OWNER
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Name | SHASHANK CHANDRA SRIVASTAVA
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Credential | DPM
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Telephone | 202-237-0038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO1000041
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License Number State | DC
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