Healthcare Provider Details

I. General information

NPI: 1629090915
Provider Name (Legal Business Name): CHANDER K. SACHDEVA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 12/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7811 MAPLE AVENUE
MERCHANTVILLE NJ
08109
US

IV. Provider business mailing address

20 FOXCROFT WAY
MOUNT LAUREL NJ
08054-5732
US

V. Phone/Fax

Practice location:
  • Phone: 856-488-1212
  • Fax: 856-488-2224
Mailing address:
  • Phone: 856-222-0229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberMD068155-L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number25MA07696600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: