Healthcare Provider Details

I. General information

NPI: 1255891818
Provider Name (Legal Business Name): RIDA SANDHU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2019
Last Update Date: 07/23/2025
Certification Date: 03/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 SAND HILL ROAD
FLEMINGTON NJ
08822
US

IV. Provider business mailing address

401 ROUTE 73 N STE 320
MARLTON NJ
08053-3426
US

V. Phone/Fax

Practice location:
  • Phone: 908-782-6700
  • Fax: 908-788-5861
Mailing address:
  • Phone: 973-383-9841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberP21-00303
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA11479600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: