Healthcare Provider Details

I. General information

NPI: 1184646697
Provider Name (Legal Business Name): JASVINDER S SANDHU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 09/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 QUAKER VILLAGE SHOPPING CTR OHIO RIVER BLVD STE 2
LEETSDALE PA
15056-1206
US

IV. Provider business mailing address

12 QUAKER VILLAGE SHOPPING CTR OHIO RIVER BLVD STE 2
LEETSDALE PA
15056-1206
US

V. Phone/Fax

Practice location:
  • Phone: 724-773-4502
  • Fax: 412-749-6787
Mailing address:
  • Phone: 724-773-4502
  • Fax: 412-749-6787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD035724E
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberMD035724E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: