Shanmugham, Revathi

Shanmugham, Revathi is an sole proprietor health care provider with primary practice located at 40 Eisenhover Drive , Paramus NJ 07652. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Shanmugham, Revathi can be contacted via phone (352) 686-2972.

Contact Information

Primary practice address
40 Eisenhover Drive Paramus NJ 07652
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 25MA08398000 New Jersey

Profile Details

NPI number 1457445033
LBN Legal business name Shanmugham, Revathi
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 3rd, 2006
Last updated Jul 20th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457445033 NPPES
Florida Other 260037453 RAILROAD MEDICARE
Florida Other 51265 RAILROAD MEDICARE
Florida MEDICAID 044684000 RAILROAD MEDICARE

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