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General NPI Number Information
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NPI Number | 1730413550
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Entity Type | Organization
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Legal Business Name | SHIVENDRA PANDEY MD PC
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Dates
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Enumeration Date | 09/25/2009
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Last Update Date | 09/25/2009
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Provider Practice Location Address
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Address Line | 2640 HIGHWAY 70 SUITE 101B BUILDING 12
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City | MANASQUAN
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State | NJ
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Zip | 08736-2609
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Country | US
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Telephone | 732-223-0008
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Fax | 732-223-8020
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Provider Business Mailing Address
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Address Line | 19 FULLING MILL LN
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City | COLTS NECK
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State | NJ
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Zip | 07722-1278
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Country | US
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Telephone | 732-223-0008
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHIVENDRA PANDEY
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Credential |
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Telephone | 732-735-5455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | MA66691
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License Number State | NJ
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