Provider Demographics
NPI:1427570605
Name:SHRIVASTAV, RISHI
Entity Type:Individual
Prefix:
First Name:RISHI
Middle Name:
Last Name:SHRIVASTAV
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 AMSTERDAM AVE APT 209
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-7489
Mailing Address - Country:US
Mailing Address - Phone:929-408-5086
Mailing Address - Fax:
Practice Address - Street 1:ONE GUSTAVE L LEVY PLACE
Practice Address - Street 2:ST LUKE ROOSEVELT HOSPITAL CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-1002
Practice Address - Country:US
Practice Address - Phone:212-241-8154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-10
Last Update Date:2017-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program