Healthcare Provider Details
I. General information
NPI: 1821088329
Provider Name (Legal Business Name): SANKAR BANDYOPADHYAY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/26/2005
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
30 HOPE DR STE 1300
HERSHEY PA
17033-2036
US
IV. Provider business mailing address
PO BOX 858 MC A410
HERSHEY PA
17033-0858
US
V. Phone/Fax
- Phone: 717-531-3828
- Fax: 717-531-4694
- Phone: 800-243-1455
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 204R00000X |
| Taxonomy | Electrodiagnostic Medicine Physician |
| License Number | 036173888 |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0008X |
| Taxonomy | Neuromuscular Medicine (Psychiatry & Neurology) Physician |
| License Number | 036173888 |
| License Number State | IL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0600X |
| Taxonomy | Clinical Neurophysiology Physician |
| License Number | 036173888 |
| License Number State | IL |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | 036173888 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: