Individual
GEETHAN SIVANANTHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
695 CHESTNUT ST, UNION, NJ 07083-7200
(908) 688-6565
Mailing address
49 HASTINGS RD, KENDALL PARK, NJ 08824-1045
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
25MA09696600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04670781
—
NJ
Enumeration date
03/31/2009
Last updated
04/04/2019
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