Basic Information
| Provider Information | |||||||||
| NPI: | 1013015395 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PILLAI | ||||||||
| FirstName: | SHIVNATHAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | SA | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 71 GROHMANS LN | ||||||||
| Address2: | |||||||||
| City: | PLAINVIEW | ||||||||
| State: | NY | ||||||||
| PostalCode: | 118035414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188304000 | ||||||||
| FaxNumber: | 7188301149 | ||||||||
| Practice Location | |||||||||
| Address1: | 10201 66TH RD | ||||||||
| Address2: | |||||||||
| City: | FOREST HILLS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113752029 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188304000 | ||||||||
| FaxNumber: | 7188301149 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 000080 | NY | Y | Other Service Providers | Specialist |
No ID Information.