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

Sivam Diabetes, Nutrition and Family Healthcare LLC

Organization Metabolic Nutrition Registered Dietitian · NPI 1568974418

Sivam Diabetes, Nutrition and Family Healthcare LLC is a Metabolic Nutrition Registered Dietitian in East Orange, New Jersey. Licensed in Illinois and New Jersey. Registered with an NPI since 2017.

Licensed in
IL, NJ
In the registry since
2017
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

240 N Arlington Ave
East Orange, NJ 07017-3802
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 · Licence 26NJ00421400 (NJ)
Metabolic Nutrition Registered Dietitian Taxonomy 133VN1006X · Licence 0071705 (IL)
Diabetes Educator Registered Nurse Taxonomy 163WD0400X · Licence 26NR11201600 (NJ)

Record details

NPI number1568974418
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mavis Faulknor — Ceo/Social Entrepreneur · (201) 618-1472
NPI enumeratedNovember 1, 2017
Last updated in NPPESNovember 1, 2017
Mailing address78 Kenmore Avenue, Newark, NJ 07106