Provider Demographics
NPI:1487016374
Name:SHIVKUMAR, ROHINI
Entity Type:Individual
Prefix:
First Name:ROHINI
Middle Name:
Last Name:SHIVKUMAR
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 1:953 ROUTE 33
Mailing Address - Street 2:
Mailing Address - City:HAMILTON SQUARE
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-2707
Mailing Address - Country:US
Mailing Address - Phone:609-890-2027
Mailing Address - Fax:
Practice Address - Street 1:953 ROUTE 33
Practice Address - Street 2:
Practice Address - City:HAMILTON SQUARE
Practice Address - State:NJ
Practice Address - Zip Code:08690-2707
Practice Address - Country:US
Practice Address - Phone:609-890-2027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02622900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist