Organization
SEQUOIA BEHAVIORAL HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HATTI SHIVUMAR MD (CEO)
(610) 891-9024
Entity
Organization
Contact information
Practice address
107 CHELSEY DRIVE, UNIT 4, MEDIA, PA 19063
(610) 891-9024
(610) 891-9699
Mailing address
107 CHELSEY DRIVE, UNIT 4, MEDIA, PA 19063
(610) 891-9024
(610) 891-9699
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
847252
—
PA
Enumeration date
07/05/2006
Last updated
10/16/2008
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