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Individual

DR. SHIVAPRASAD MARULENDRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
27 TARA WAY, PENNINGTON, NJ 08534-2100
(609) 477-3003
Mailing address
27 TARA WAY, PENNINGTON, NJ 08534-2100
(609) 477-3003

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
25MA06405900
NJ
207RG0100X
Gastroenterology Physician
036141750
IL
207RG0100X
Gastroenterology Physician
Primary
25MA06405900
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000653760001
ONE HEALTH PLAN
NJ
01
010002878-00
AMERICHOICE
NJ
01
0985179000
AMERIHEALTH HMO
NH
01
1091534
HORIZON NJ HEALTH
NJ
01
143398
CHN
NJ
01
16536
AMERICAID
NJ
01
214881
MEDICARE GROUP PTAN
IL
01
2172624
AETNA HMO
NJ
01
222233588
MULTIPLAN
NH
01
222233588
HORIZON BC/BS
NJ
01
28B141
EMPIRE HEALTH CARE
NH
01
2K7529
HEALTHNET
NJ
01
3977218008
CIGNA
NH
01
4651687
AETNAPPO
NJ
01
5711065
GHI
NJ
01
63162
LOCAL 825 PPO
NJ
05
7050607
NJ
01
744595
FIRST HEALTH
NH
01
869482
AMERIHEALTH PPO
NJ
Enumeration date
12/06/2005
Last updated
01/16/2026
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