Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Sivam Diabetes & Primary Care LLC

Organization Registered Dietitian · NPI 1710525662

Sivam Diabetes & Primary Care LLC is a Registered Dietitian in Newark, New Jersey. Registered with an NPI since 2019.

In the registry since
2019
Specialties on file
4
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1120-1122 S Orange Ave
Newark, NJ 07106
Phone: (201) 618-1472
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X
Registered Dietitian Taxonomy 133V00000X
Diabetes Educator Registered Nurse Taxonomy 163WD0400X
Health Service Clinic/Center Taxonomy 261QH0100X

Record details

NPI number1710525662
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mavis Ermakov — Director/Ceo · (201) 618-1472
Other names Sivam Diabetes, Nutrition And Family Healthcare; Sivam Diabetes, Nutrition And Family Healthcare
NPI enumeratedDecember 11, 2019
Last updated in NPPESSeptember 1, 2021
Certification dateAugust 16, 2021
Mailing address78 Kenmore Ave, Newark, NJ 07106-1026

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