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General NPI Number Information
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NPI Number | 1598193815
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Entity Type | Organization
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Legal Business Name | TULIKA SRIVASTAVA, LLC
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Dates
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Enumeration Date | 10/23/2013
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Last Update Date | 10/23/2013
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Provider Practice Location Address
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Address Line | 491 CLOSTER DOCK RD
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City | CLOSTER
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State | NJ
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Zip | 07624-3129
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Country | US
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Telephone | 201-805-2665
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Fax | 201-367-3428
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Provider Business Mailing Address
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Address Line | 33 HILLSIDE AVE
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City | NORWOOD
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State | NJ
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Zip | 07648-1721
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Country | US
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Telephone | 201-805-2665
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Fax | 201-367-3428
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Authorized Official
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Title or Position | CEO
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Name | DR. TULIKA SINHA SRIVASTAVA
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Credential | M.D.
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Telephone | 201-805-2665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | MA72084
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License Number State | NJ
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