Provider Demographics
NPI:1891062493
Name:SRIVASTAVA, AJITABH (MD)
Entity Type:Individual
Prefix:DR
First Name:AJITABH
Middle Name:
Last Name:SRIVASTAVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URMC STRONG MEMORIAL HOSPITAL
Mailing Address - Street 2:601, ELMWOOD AVENUE
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-273-3881
Mailing Address - Fax:585-276-2182
Practice Address - Street 1:URMC STRONG MEMORIAL HOSPITAL
Practice Address - Street 2:601, ELMWOOD AVENUE
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-273-3881
Practice Address - Fax:585-276-2182
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-27
Last Update Date:2011-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital