Healthcare Provider Details

I. General information

NPI: 1063619542
Provider Name (Legal Business Name): BANI CHANDER ROLAND MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BANI CHANDER MD

II. Dates (important events)

Enumeration Date: 06/28/2007
Last Update Date: 03/17/2023
Certification Date: 03/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 FT WASHINGTN AVE
NEW YORK NY
10032-3729
US

IV. Provider business mailing address

161 FT WASHINGTN AVE SUITE 862
NEW YORK NY
10032-3729
US

V. Phone/Fax

Practice location:
  • Phone: 212-305-1021
  • Fax:
Mailing address:
  • Phone: 917-692-6745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberDR.0070529
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberD74626
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: