Provider Demographics
NPI:1710064738
Name:SIVAK, DENIS (MD)
Entity Type:Individual
Prefix:
First Name:DENIS
Middle Name:
Last Name:SIVAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:946 TROPIC BLVD
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-4955
Mailing Address - Country:US
Mailing Address - Phone:203-722-9665
Mailing Address - Fax:203-222-7180
Practice Address - Street 1:946 TROPIC BLVD
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-4955
Practice Address - Country:US
Practice Address - Phone:203-722-9665
Practice Address - Fax:203-222-7180
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT018281207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A34959Medicare UPIN