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Contact Information

KALYANI THEIVANAYAGAM, MD
276 WOODLAND AVE
SUMMIT, NJ07901-1437
 Phone: 973-669-8181
 Fax: 973-669-1687
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for KALYANI THEIVANAYAGAM · (Female)

NPI # 1598878910
Status Active
Credentials MD
Entity Individual
Enumeration date 08/17/2006
Last updated 12/23/2010 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • NJ License # 25MA06857500
  • NJ Medicaid 7878109
Hospital affiliation(s)
  • SAINT BARNABAS MEDICAL CENTER - (Acute Care)
    94 OLD SHORT HILLS ROAD
    LIVINGSTON, NJ 07039
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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