MEDICARE: MEERA SIVENDRAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	25MA09474400	NJ
2	207N00000X	Dermatology Physician	MD469050	PA

General Provider Information

NPI Number	:	1245551779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEERA SIVENDRAN M.D.

Provider Business Mailing Address
First Line	:	3600 SPRUCE ST
Second Line	:	2 MALONEY
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-6144
Country	:	US
Telephone Number	:	610-902-2400
Fax Number	:	610-902-2404

Provider Business Practice Location Address
First Line	:	145 KING OF PRUSSIA ROAD
Second Line	:	SUITE 306 SOUTH
City	:	RADNOR
State	:	PA
Zip	:	19087-4557
Country	:	US
Telephone Number	:	610-902-2400
Fax Number	:	610-902-2404

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2010
Last Update Date	:	07/22/2025

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