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General NPI Number Information
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NPI Number | 1871692913
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Entity Type | Individual
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Provider Name | BRENDA C. SISON M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 94 OLD SHORT HILLS RD
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City | LIVINGSTON
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State | NJ
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Zip | 07039-5672
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Country | US
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Telephone | 973-322-2800
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Fax | 973-322-2856
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Provider Business Mailing Address
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Address Line | 117 HEMLOCK RD
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City | SHORT HILLS
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State | NJ
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Zip | 07078-1823
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Country | US
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Telephone | 973-322-8074
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Fax | 973-322-2856
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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 | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number | MA054029
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License Number State | NJ
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