Provider Demographics
NPI:1902244536
Name:SHRIVASTAVA, TRIPTI
Entity Type:Individual
Prefix:
First Name:TRIPTI
Middle Name:
Last Name:SHRIVASTAVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 GRANDVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-5113
Mailing Address - Country:US
Mailing Address - Phone:915-544-6750
Mailing Address - Fax:
Practice Address - Street 1:1901 GRANDVIEW AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-5113
Practice Address - Country:US
Practice Address - Phone:915-544-6750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS