Sivam Diabetes & Primary Care LLC
Nurse Practitioner, Family in Newark, New Jersey
1710525662- Practice location
- 1120-1122 South Orange Avenue, Newark, NJ 07106
- Phone
- 201-618-1472
- Fax
- —
- Last updated
- September 1, 2021
Sivam Diabetes & Primary Care LLC is a healthcare organization based in Newark, NJ. Sivam Diabetes & Primary Care LLC practices in Newark, NJ. The NPI Number for Sivam Diabetes & Primary Care LLC is 1710525662. The current practice location address for Sivam Diabetes & Primary Care LLC is 1120-1122 South Orange Avenue, Newark, NJ 07106 and can be reached out via phone at 201-618-1472.
Provider Profile Details
- NPI Number
- 1710525662
- Provider Name
- Sivam Diabetes & Primary Care LLC
- Provider Entity Type
- Organization
- Address
- 1120-1122 South Orange Avenue, Newark, NJ 07106
- Phone Number
- 201-618-1472
- Primary Taxonomy
- Nurse Practitioner, Family · 363LF0000X
- Organization Subpart
- No
- Authorized Official
- Dr. Mavis Camalita Ermakov, DNP, APN, FHNP-BC, R · Director/Ceo · 201-618-1472
- Other Names
- Sivam Diabetes, Nutrition And Family Healthcare (Doing Business As)
- Provider Enumeration Date
- December 11, 2019
- Last Update Date
- September 1, 2021
- Certification Date
- August 16, 2021
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1120-1122 South Orange Avenue
Newark, NJ 07106 - City
- Newark
- State
- New Jersey
- Zip
- 07106
- Phone Number
- 201-618-1472
Provider Business Mailing Address Details
- Address
- 78 Kenmore Ave
Newark, NJ 07106-1026 - City
- Newark
- State
- NJ
- Zip
- 07106-1026
- Phone Number
- 201-618-1472
License Information
- Taxonomy (1)
- Dietitian, Registered · 133V00000X
- Taxonomy (2)
- Registered Nurse, Diabetes Educator · 163WD0400X
- Taxonomy (3)
- Clinic/Center, Health Services · 261QH0100X
- Taxonomy (4)
- Nurse Practitioner, Family · 363LF0000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Sivam Diabetes & Primary Care LLC?
The NPI number of Sivam Diabetes & Primary Care LLC is 1710525662. It was assigned on December 11, 2019 and is currently active in the NPPES registry.
What is the specialty of Sivam Diabetes & Primary Care LLC?
Sivam Diabetes & Primary Care LLC is registered under the primary taxonomy Nurse Practitioner, Family (code 363LF0000X).
Where does Sivam Diabetes & Primary Care LLC practice?
The practice location is 1120-1122 South Orange Avenue, Newark, NJ 07106. The office can be reached at 201-618-1472 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1710525662 directly on the NPPES registry website.