PROSPECT MEDICAL PC NPI 1346365905

NPI Information

  • NPI: 1346365905
  • Provider Name: PROSPECT MEDICAL PC
  • Classification: Internal Medicine - 207R00000X
  • Entity Type: Organization
  • Address: 277 PROSPECT AVE
    HACKENSACK, NJ
    ZIP 07601
  • Phone: (201) 968-1881

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NPI Details

PROSPECT MEDICAL PC is an internal medicine in Hackensack, NJ. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. PROSPECT MEDICAL PC NPI is 1346365905. The provider is registered as an organization entity type.

The provider's business location address is:

277 PROSPECT AVE
HACKENSACK, NJ
ZIP 07601-570
Phone: (201) 968-1881
Fax: (201) 968-0330

The provider's authorized official is Shan Sivendra .
The authorized official title is President and has the following contact phone number (201) 968-1881.

The enumeration date for this NPI number is 3/20/2007 and was last updated on 8/1/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2207R00000XInternal Medicine25MA06930200NEW JERSEYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1201403274OTHERNEW JERSEYTAX ID
27129790001MEDICARE NSCNEW JERSEY
3H07358MEDICARE UPINNEW JERSEY
4086855MEDICARE ID-TYPE UNSPECIFIEDNEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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