Healthcare Provider Details

I. General information

NPI: 1093580706
Provider Name (Legal Business Name): MR. ARJUN PRATAP SINGH SANDHU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2023
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date: 06/24/2024
Reactivation Date: 07/30/2026

III. Provider practice location address

23 KENNEDY STREET SUITE 101
BRADFORD PA
16701
US

IV. Provider business mailing address

23 KENNEDY STREET SUITE 101
BRADFORD PA
16701
US

V. Phone/Fax

Practice location:
  • Phone: 716-375-7500
  • Fax: 716-701-6853
Mailing address:
  • Phone: 716-375-7500
  • Fax: 716-701-6853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
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: