Prospect Medical Pc

LBN: Prospect Medical Pc
Prospect Medical Pc is an health care organization with primary practice located at 277 Prospect Ave , Hackensack NJ 07601-2570. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Suppliers / Durable Medical Equipment & Medical Supplies. Allopathic & Osteopathic Physicians / Internal Medicine is the primary health care specialty. Prospect Medical Pc can be contacted via phone (201) 968-1881, or through Sivendra, Shan via phone (201) 968-1881.

Contact Information

Primary practice address
277 Prospect Ave Hackensack NJ 07601-2570
Fax: (201) 968-0330
Website:
Authorized official contact:
Name: Sivendra, Shan Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 25MA06930200 New Jersey
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X

Profile Details

NPI number 1346365905
LBN Legal business name Prospect Medical Pc
DBA Doing business as
Authorized official Sivendra, Shan Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 20th, 2007
Last updated Aug 1st, 2014 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346365905 NPPES
New Jersey Other 201403274 TAX ID

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