Individual provider · Type 1 NPI

Shivashankara Swamy Mathighatta Shivarudraiah

Student in an Organized Health Care Education/Training Program · Brooklyn, NY

NPI number 1154268449 Active

Practice location

4802 10th Ave
Brooklyn, NY 11219

Call (718) 283-6000 Map

Mailing address

1054 41 Street Apt 2G, Apt 2G
Brooklyn, NY 11219

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1154268449

Shivashankara Swamy Mathighatta Shivarudraiah's National Provider Identifier is 1154268449, issued on May 4, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Brooklyn, NY. The record was last updated on May 4, 2026.