Provider Demographics
NPI:1447822093
Name:SIVAJI, SHERMI
Entity type:Individual
Prefix:
First Name:SHERMI
Middle Name:
Last Name:SIVAJI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 FIELD CLUB CIR
Mailing Address - Street 2:
Mailing Address - City:MC KEES ROCKS
Mailing Address - State:PA
Mailing Address - Zip Code:15136-1033
Mailing Address - Country:US
Mailing Address - Phone:412-491-0177
Mailing Address - Fax:
Practice Address - Street 1:222 FIELD CLUB CIR
Practice Address - Street 2:
Practice Address - City:MC KEES ROCKS
Practice Address - State:PA
Practice Address - Zip Code:15136-1033
Practice Address - Country:US
Practice Address - Phone:412-491-0177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN694640163W00000X
PA145728367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse