Prospect Medical PC

NPI #1346365905 in Hackensack, New Jersey

Provider Information

NPI Number: 1346365905
Entity Type: Organization
Organization Name: Prospect Medical PC
Primary Specialty: Internal Medicine
Enumeration Date: Mar 20, 2007
Last Updated: Aug 1, 2014

Practice Location

Address: 277 PROSPECT AVE
City: Hackensack
State: New Jersey
ZIP Code: 07601-2570
Phone: (201) 968-1881

Authorized Official

Name: DR. SHAN SIVENDRA, M.D.
Title: PRESIDENT
Phone: (201) 968-1881

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Durable Medical Equipment & Medical Supplies	332B00000X
Internal Medicine	207R00000X	Primary

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