Provider Demographics
NPI:1003876186
Name:ACHAR, PANKAJA (MD)
Entity Type:Individual
Prefix:DR
First Name:PANKAJA
Middle Name:
Last Name:ACHAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PANKAJA
Other - Middle Name:
Other - Last Name:NAGANANDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:815 NEW DOVER RD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820
Mailing Address - Country:US
Mailing Address - Phone:732-662-7475
Mailing Address - Fax:973-623-1235
Practice Address - Street 1:194 CLINTON AVE FL 2
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07108-2809
Practice Address - Country:US
Practice Address - Phone:973-273-1515
Practice Address - Fax:973-230-0883
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJTLH50838207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6459706Medicaid
602803MJVMedicare ID - Type Unspecified
E01413Medicare UPIN