Provider Demographics
NPI:1750622031
Name:SHRIVASTAVA, RAM KUMAR (MD)
Entity type:Individual
Prefix:
First Name:RAM
Middle Name:KUMAR
Last Name:SHRIVASTAVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:737 PARK AVE
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4243
Mailing Address - Country:US
Mailing Address - Phone:212-288-0138
Mailing Address - Fax:212-288-3544
Practice Address - Street 1:737 PARK AVE
Practice Address - Street 2:SUITE 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4243
Practice Address - Country:US
Practice Address - Phone:212-288-0138
Practice Address - Fax:212-288-3544
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY147946-12084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry