Individual
DR. KEASHAVA SHIVASHANKAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
140 BELMONT AVE, STE 102, BELLEVILLE, NJ 07109-1018
(973) 751-7870
(973) 751-7870
Mailing address
140 BELMONT AVE, STE102, BELLEVILLE, NJ 07109-1018
(973) 751-7870
(973) 751-7870
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
25MA04015400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1973606
—
NJ
Enumeration date
12/18/2006
Last updated
02/28/2014
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