Provider Demographics
NPI:1982109740
Name:SIVAKUMAR, HARAN (MD)
Entity Type:Individual
Prefix:
First Name:HARAN
Middle Name:
Last Name:SIVAKUMAR
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 1:99 WALL ST STE 475
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10005-4301
Mailing Address - Country:US
Mailing Address - Phone:917-284-8973
Mailing Address - Fax:956-394-1214
Practice Address - Street 1:99 WALL ST STE 475
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10005-4301
Practice Address - Country:US
Practice Address - Phone:917-284-8973
Practice Address - Fax:956-394-1214
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY312837207Q00000X, 207QA0401X
CAA163513207QA0401X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine