MEDICARE: BHAVINI S CHANDARANA MD LLC

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	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	25MA07852000	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	:	1710140926
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BHAVINI S CHANDARANA MD LLC

Provider Business Mailing Address
First Line	:	420 ROUTE 34 STE 317
Second Line	:
City	:	COLTS NECK
State	:	NJ
Zip	:	07722-2517
Country	:	US
Telephone Number	:	732-414-6499
Fax Number	:	732-510-6499

Provider Business Practice Location Address
First Line	:	420 ROUTE 34 STE 317
Second Line	:
City	:	COLTS NECK
State	:	NJ
Zip	:	07722-2517
Country	:	US
Telephone Number	:	732-414-6499
Fax Number	:	844-890-8439

Authorized Official
Title or Position	:	DR
Name	:	BHAVINI CHANDARANA
Credential	:
Telephone Number	:	732-414-6499

Provider Enumeration Date	:	07/08/2008
Last Update Date	:	04/17/2019

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