| NPI | 1710525662 |
|---|---|
| Doing Business As | SIVAM DIABETES, NUTRITION AND FAMILY HEALTHCARE |
| Entity Type | Organization |
| Authorized Contact | MAVIS CAMALITA ERMAKOV Director/CEO 201-618-1472 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| 163WD0400X Registered Nurse, Diabetes Educator | |
| 261QH0100X Clinic/Center, Health Services | |
| Enumeration Date | 2019-12-11 |
| Last Update Date | 2021-09-01 |