Individual
DR. SHIVI S SIVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
600 NORTHERN BLVD STE 111, GREAT NECK, NY 11021-5200
(516) 387-3990
Mailing address
600 NORTHERN BLVD STE 111, GREAT NECK, NY 11021-5200
(516) 387-3990
(309) 277-1191
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
036138438
IL
207RG0100X
Gastroenterology Physician
11017474A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036138438
—
IL
Enumeration date
09/30/2013
Last updated
07/28/2021
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