Healthcare Provider Details

I. General information

NPI: 1972555753
Provider Name (Legal Business Name): SIVART LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

264 ROUTE 206
FLANDERS NJ
07836-9049
US

IV. Provider business mailing address

264 ROUTE 206
FLANDERS NJ
07836-9049
US

V. Phone/Fax

Practice location:
  • Phone: 973-584-5844
  • Fax: 973-584-1212
Mailing address:
  • Phone: 973-584-5844
  • Fax: 973-584-1212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberC0000195277
License Number StateNJ

VIII. Authorized Official

Name: CHRIS GARVIN
Title or Position: PRESIDENT
Credential:
Phone: 973-584-5844