Prospect Medical Pc
Internal Medicine
277 Prospect Ave, Hackensack
New Jersey, 07601-2570
201-968-1881 201-968-0330
Prospect Medical Pc is a Internal Medicine in Hackensack, New Jersey. It is located at 277 Prospect Ave, Hackensack and it's customer support contact number is 201-968-1881. The authorized person of Prospect Medical Pc is Dr. Shan Sivendra, M.D. who is President of this DME and his contact number is 201-968-1881. Active license number of Prospect Medical Pc is 25MA06930200 for Internal Medicine in New Jersey. Prospect Medical Pc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Prospect Medical Pc is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
DME Supplier Details:
Prospect Medical Pc type, location, contact phone number and fax are as below. Patients can directly walkin or can call on the below given customer support phone number for enquiries.
| Name: | Prospect Medical Pc |
| Type: | Internal Medicine |
| Location: | 277 Prospect Ave, Hackensack,
New Jersey, 07601-2570 |
| Phone: | 201-968-1881 |
| Fax: | 201-968-0330 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this supplier is as below. Person's position and contact details are also mentioned below.
| Name: | Dr. Shan Sivendra |
| Credentials: | M.D. |
| Position: | President |
| Contact Number: | 201-968-1881 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given supplier are as mentioned below.
| NPI Number: | 1346365905 |
| NPI Enumeration Date: | 20 Mar, 2007 |
| NPI Last Update On: | 01 Aug, 2014 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Prospect Medical Pc are as mentioned below.
| Specialization | License Number | State | Status | |
| Internal Medicine | 25MA06930200 | New Jersey | Primary | |
| Durable Medical Equipment & Medical Supplies | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of this supplier such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 201403274 | Other | New Jersey | Tax Id |
Medicare Enrollment:
Prospect Medical Pc is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 4486602737 | O20050104000551 | Prospect Medical Pc | PART B SUPPLIER - CLINIC/GROUP PRACTICE |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 277 Prospect Ave, Unit Lg
Hackensack, New Jersey |
| Zip: | 07601-2512 |
| Phone Number: | 201-968-1881 |
| Fax Number: | 201-968-0330 |
Patients can reach Prospect Medical Pc at
277 Prospect Ave, Hackensack, New Jersey or can
call on customer care at 201-968-1881.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.