Sivendra, Shan
Sivendra, Shan is an sole proprietor health care provider with primary practice located at 94 Old Short Hills Rd , Livingston NJ 07039-5672. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Sivendra, Shan can be contacted via phone (201) 322-5000.Contact Information
Primary practice address
94 Old Short Hills Rd
Livingston NJ 07039-5672
Phone: (201) 322-5000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 25MA06930200 | New Jersey |
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 25MA06930200 | New Jersey |
Profile Details
| NPI number | 1538154307 |
|---|---|
| LBN Legal business name | Sivendra, Shan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 16th, 2005 |
| Last updated | Feb 22nd, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538154307 | NPPES |
| New Jersey | MEDICAID | 8222801 |
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