Individual
AHILAN SIVAGANESAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 CIVIC CENTER BLVD, 2ND FLR. SOUTH PAVILION, PHILADELPHIA, PA 19104-4238
(215) 662-3487
(215) 349-5534
Mailing address
3400 CIVIC CENTER BLVD, 2ND FLR. SOUTH PAVILION, PHILADELPHIA, PA 19104-4238
(215) 662-3487
(215) 349-5534
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
MD474192
PA
207T00000X
Neurological Surgery Physician
Primary
ME168845
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123078700
—
FL
01
—
GAGZN
BCBS
FL
Enumeration date
05/01/2013
Last updated
07/09/2026
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