MEDICARE: PANDYA DERMATOLOGY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician

General Provider Information

NPI Number	:	1194657676
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PANDYA DERMATOLOGY

Provider Business Mailing Address
First Line	:	PO BOX 16
Second Line	:
City	:	BLAWENBURG
State	:	NJ
Zip	:	08504-0016
Country	:	US
Telephone Number	:	908-758-4373
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 MORRISTOWN RD STE 1A
Second Line	:
City	:	BERNARDSVILLE
State	:	NJ
Zip	:	07924-2310
Country	:	US
Telephone Number	:	908-758-4373
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KOMAL PANDYA
Credential	:
Telephone Number	:	908-758-4373

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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