Healthcare Provider Details

I. General information

NPI: 1851929822
Provider Name (Legal Business Name): SUBHASHINI CHANDRASEKARAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CORPORATE DR
WAYNE NJ
07470-3112
US

IV. Provider business mailing address

1 CORPORATE DR
WAYNE NJ
07470-3112
US

V. Phone/Fax

Practice location:
  • Phone: 120-176-6515
  • Fax:
Mailing address:
  • Phone: 201-766-5151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number25MA12687100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME167099
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: