Revathi Shanmugham (NPI# 1457445033, PAC ID# 2668360629) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PSYCHIATRY.
| Nation Provider ID (NPI) | 1457445033 |
| PAC ID by PECOS | 2668360629 |
| Professional Enrollment ID | I20090414000413 |
| Full Name | Revathi Shanmugham |
| Organization Legal Name | PRIME HEALTHCARE SERVICES- ST MARY'S PASSAIC LLC |
| Address |
350 Boulevard Passaic NJ 07055-2840 |
| Phone Number | 9733654300 |
| Gender | F |
| Credential | MD |
| Graduation Year | 1969 |
| Primary Specialty | PSYCHIATRY |
| Group Practice PAC ID | 6305066911 |
| Number of Group Practice Members | 16 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 310006 | ST MARY'S GENERAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 350 Boulevard, Passaic, NJ 07055-2840 | 9733654300 | PRIME HEALTHCARE SERVICES- ST MARY'S PASSAIC LLC |
| Organization Legal Name | PRIME HEALTHCARE SERVICES- ST MARY'S PASSAIC LLC |
| Physicians | 8 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Frank Gingerelli | Diagnostic Radiology | Prime Healthcare Services- St Mary's Passaic LLC | 350 Boulevard, Passaic, NJ 07055-2840 |
| Vincent Gallo | Interventional Radiology | Prime Healthcare Services- St Mary's Passaic LLC | 350 Boulevard, Passaic, NJ 07055-2840 |
| Nazia Khan | Internal Medicine | Prime Healthcare Services- St Mary's Passaic LLC | 350 Boulevard, Passaic, NJ 07055-2840 |
| Brijal M Desai | Radiation Oncology | Prime Healthcare Services- St Mary's Passaic LLC | 350 Boulevard, Passaic, NJ 07055-2840 |
| Alan Weisman | Clinical Social Worker | Prime Healthcare Services- St Mary's Passaic LLC | 350 Boulevard, Passaic, NJ 07055-2840 |
| Jennifer Mekkawy | Clinical Social Worker | Prime Healthcare Services- St Mary's Passaic LLC | 350 Boulevard, Passaic, NJ 07055-2840 |
| Julie A Sisselman | Clinical Social Worker | Prime Healthcare Services- St Mary's Passaic LLC | 350 Boulevard, Passaic, NJ 07055-2840 |
| Street Address |
350 BOULEVARD |
| City | PASSAIC |
| State | NJ |
| Zip | 07055-2840 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sean M Kelly | Internal Medicine | Inhospital Physicians Corp of New Jersey, PC | 350 Boulevard, Passaic, NJ 07055-2840 |
| Ghassan M Chehade | Cardiovascular Disease (cardiology) | Ghcp Ekg Interpretation Panel, LLC | 350 Boulevard, Passaic, NJ 07055-2840 |
| Sandra A Uzzalino | Nurse Practitioner | Inhospital Physicians Corp of New Jersey, PC | 350 Boulevard, Passaic, NJ 07055-2840 |
| Ghassan G Bassil | Pathology | Mario Gonzalez, Md | 350 Boulevard, Passaic, NJ 07055-2840 |
| Robert M Bazzini | Orthopedic Surgery | Advanced Perioperative Medicine, P.a. | 350 Boulevard, Passaic, NJ 07055-2840 |
| Christopher Kizina | Pain Management | Advanced Perioperative Medicine, P.a. | 350 Boulevard, Passaic, NJ 07055-2840 |
| John G Cubero | Cardiovascular Disease (cardiology) | Ghcp Ekg Interpretation Panel, LLC | 350 Boulevard, Passaic, NJ 07055-2840 |
| Barbara B. Haralson | Emergency Medicine | Emergency Associates of St Marys LLC | 350 Boulevard, Passaic, NJ 07055-2840 |
| Frank Gingerelli | Diagnostic Radiology | Prime Healthcare Services- St Mary's Passaic LLC | 350 Boulevard, Passaic, NJ 07055-2840 |
| Anthony I Okafor | Emergency Medicine | Emergency Associates of St Marys LLC | 350 Boulevard, Passaic, NJ 07055-2840 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Yaakov Siegel | Psychologist, Clinical | Senior Care Therapy LLC | 85 Crescent Ave, Passaic, NJ 07055-2437 |
| Kelly B Hargadon | Psychologist, Clinical | Senior Care Therapy LLC | 85 Crescent Ave, Passaic, NJ 07055-2437 |
| Sherri S Tucker | Clinical Social Worker | Senior Care Therapy LLC | 85 Crescent Ave, Passaic, NJ 07055-2437 |
| Kristin Ann Motta | Clinical Social Worker | Senior Care Therapy LLC | 85 Crescent Ave, Passaic, NJ 07055-2437 |
| Sherri C Goldstein | Clinical Social Worker | Senior Care Therapy LLC | 85 Crescent Ave, Passaic, NJ 07055-2437 |
| Amanda Romeo | Clinical Social Worker | Senior Care Therapy LLC | 85 Crescent Ave, Passaic, NJ 07055-2437 |
| Elizabeth C Miller | Clinical Social Worker | Senior Care Therapy LLC | 85 Crescent Ave, Passaic, NJ 07055-2437 |
| Heather Miller | Clinical Social Worker | Senior Care Therapy LLC | 85 Crescent Ave, Passaic, NJ 07055-2437 |
| Daria Malinchak Mcphee | Clinical Social Worker | Senior Care Therapy LLC | 85 Crescent Ave, Passaic, NJ 07055-2437 |
| Sarah C. Hiller | Clinical Social Worker | Senior Care Therapy LLC | 85 Crescent Ave, Passaic, NJ 07055-2437 |
| Find all physicians in zip 07055 | |||
| City | PASSAIC |
| Zip Code | 07055 |
| Specialty | PSYCHIATRY |
| City + Specialty | PASSAIC + PSYCHIATRY |
Please comment or provide details below to improve the information on Revathi Shanmugham.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.