Healthcare Provider Details

I. General information

NPI: 1336257666
Provider Name (Legal Business Name): SIVANI S. PATHMARAJAH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2006
Last Update Date: 03/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8050 BECKETT CENTER DR STE 108
WEST CHESTER OH
45069-5017
US

IV. Provider business mailing address

8050 BECKETT CENTER DR STE 108
WEST CHESTER OH
45069-5017
US

V. Phone/Fax

Practice location:
  • Phone: 513-618-7430
  • Fax: 513-280-8868
Mailing address:
  • Phone: 513-618-7430
  • Fax: 513-280-8868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35-088059
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35-088059
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: