Provider Demographics
NPI:1699203083
Name:AMARNATH, SHIVANTHA (MD)
Entity Type:Individual
Prefix:MR
First Name:SHIVANTHA
Middle Name:
Last Name:AMARNATH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:AMARNATH
Other - Middle Name:
Other - Last Name:SHIVANTHA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:475 SEAVIEW AVENUE
Mailing Address - Street 2:STATEN ISLAND UNIVERSITY HOSPITAL
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305
Mailing Address - Country:US
Mailing Address - Phone:718-226-6205
Mailing Address - Fax:
Practice Address - Street 1:475 SEAVIEW AVE
Practice Address - Street 2:STATEN ISLAND UNIVERSITY HOSPITAL
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305
Practice Address - Country:US
Practice Address - Phone:718-226-6205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2022-07-21
Deactivation Date:2018-01-03
Deactivation Code:
Reactivation Date:2018-01-24
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program