Healthcare Provider Details

I. General information

NPI: 1235056896
Provider Name (Legal Business Name): SANDHYA RAO BASSIN MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 WOODWARD DR STE A
OLD BRIDGE NJ
08857-3374
US

IV. Provider business mailing address

14 WOODWARD DR STE A
OLD BRIDGE NJ
08857-3374
US

V. Phone/Fax

Practice location:
  • Phone: 732-334-5800
  • Fax: 732-360-4888
Mailing address:
  • Phone: 732-334-5800
  • Fax: 732-360-4888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: SANDHYA BASSIN
Title or Position: PHYSICIAN
Credential: MD
Phone: 732-334-5800