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General NPI Number Information
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NPI Number | 1255458105
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Entity Type | Individual
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Provider Name | BALDEV SINGH SANDHU M,D.,
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Gender | Male
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Dates
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Enumeration Date | 03/24/2007
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Last Update Date | 03/21/2011
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Provider Practice Location Address
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Address Line | 600 E PALISADE AVE
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City | ENGLEWOOD CLIFFS
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State | NJ
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Zip | 07632-1828
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Country | US
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Telephone | 201-337-6286
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Fax |
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Provider Business Mailing Address
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Address Line | 600 E PALISADE AVE
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City | ENGLEWOOD CLIFFS
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State | NJ
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Zip | 07632-1828
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Country | US
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Telephone | 201-337-6286
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 25MA05286200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | 25MA05286200
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License Number State | NJ
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