Individual
DR. SHIVENDRA PANDEY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
204 JACK MARTIN BLVD, SUITE C3, BRICK, NJ 08724-7770
(732) 840-0880
(732) 840-3499
Mailing address
19 FULLING MILL LN, COLTS NECK, NJ 07722-1278
(732) 840-0880
(732) 840-3499
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
25MA06669100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8177201
—
NJ
Enumeration date
04/24/2006
Last updated
06/29/2016
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