Provider Demographics
NPI:1942725049
Name:SIVAKUMAR, MANGAIYARKKARASI (MD MS)
Entity Type:Individual
Prefix:DR
First Name:MANGAIYARKKARASI
Middle Name:
Last Name:SIVAKUMAR
Suffix:
Gender:F
Credentials:MD MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:485 GEORGES RD STE 114
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08810-2439
Mailing Address - Country:US
Mailing Address - Phone:888-460-1151
Mailing Address - Fax:
Practice Address - Street 1:485 GEORGES RD STE 114
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:NJ
Practice Address - Zip Code:08810-2439
Practice Address - Country:US
Practice Address - Phone:888-460-1151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-09
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10945300207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism