MEDICARE: PARMINDERJEET S. SANDHU

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MA045702	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033298252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PARMINDERJEET S. SANDHU

Provider Business Mailing Address
First Line	:	137 MOUNTAIN AVE
Second Line	:
City	:	HACKETTSTOWN
State	:	NJ
Zip	:	07840-2307
Country	:	US
Telephone Number	:	908-852-1887
Fax Number	:

Provider Business Practice Location Address
First Line	:	137 MOUNTAIN AVE
Second Line	:
City	:	HACKETTSTOWN
State	:	NJ
Zip	:	07840-2307
Country	:	US
Telephone Number	:	908-852-1887
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	07/08/2007

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