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General NPI Number Information
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NPI Number | 1356617997
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Entity Type | Individual
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Provider Name | SHAWN SIDHARTHAN MD
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Gender | Male
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Dates
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Enumeration Date | 03/28/2012
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 596 ANDERSON AVE STE 216
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City | CLIFFSIDE PARK
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State | NJ
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Zip | 07010-1856
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Country | US
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Telephone | 201-772-2329
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Fax |
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Provider Business Mailing Address
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Address Line | 90 MATAWAN RD STE 302
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City | MATAWAN
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State | NJ
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Zip | 07747-2653
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Country | US
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Telephone | 732-441-7177
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Fax | 732-441-7165
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 281570-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 25MA12047200
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 25MA12047200
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 281570-1
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 281570-1
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License Number State | NY
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