Provider Demographics
NPI:1245517226
Name:S SIVAMURTHY MD PC
Entity type:Organization
Organization Name:S SIVAMURTHY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHETRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIVAMURTHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-526-3899
Mailing Address - Street 1:8934 134TH ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11418-2819
Mailing Address - Country:US
Mailing Address - Phone:718-526-3899
Mailing Address - Fax:718-526-3233
Practice Address - Street 1:8934 134TH ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11418-2819
Practice Address - Country:US
Practice Address - Phone:718-526-3899
Practice Address - Fax:718-526-3233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-04
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty