Thusha Sivanantham
Nurse Practitioner, Primary Care in Allentown, PA. Individual provider (NPI-1).
NPI number1467099531
StatusActive
Last updated in NPPESSep 16, 2022
Details
- NPI
- 1467099531
- Entity type
- Individual (NPI-1)
- Name
- Thusha Sivanantham
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 7, 2019
- Certification date
- Sep 16, 2022
- Last updated
- Sep 16, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP2300X | Nurse Practitioner, Primary Care | SP021255 | PA | Yes |
| 363LA2200X | Nurse Practitioner, Adult Health | SP021255 | PA | |
| 363LG0600X | Nurse Practitioner, Gerontology | SP021255 | PA |
Practice location
1250 S Cedar Crest Blvd Ste 400Allentown, PA 18103-6224
Phone 610-402-6555
Mailing address
2100 Mack BlvdAllentown, PA 18103-5622
Phone 484-884-4500
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