Provider Demographics
NPI:1598193815
Name:TULIKA SRIVASTAVA, LLC
Entity Type:Organization
Organization Name:TULIKA SRIVASTAVA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TULIKA
Authorized Official - Middle Name:SINHA
Authorized Official - Last Name:SRIVASTAVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-805-2665
Mailing Address - Street 1:33 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07648-1721
Mailing Address - Country:US
Mailing Address - Phone:201-805-2665
Mailing Address - Fax:201-367-3428
Practice Address - Street 1:491 CLOSTER DOCK RD
Practice Address - Street 2:
Practice Address - City:CLOSTER
Practice Address - State:NJ
Practice Address - Zip Code:07624-3129
Practice Address - Country:US
Practice Address - Phone:201-805-2665
Practice Address - Fax:201-367-3428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-23
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA720842084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty