Provider Demographics
NPI:1013190651
Name:CHANDRA, AVINASH
Entity Type:Individual
Prefix:DR
First Name:AVINASH
Middle Name:
Last Name:CHANDRA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 CHAPMAN ROAD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702
Mailing Address - Country:US
Mailing Address - Phone:302-623-1929
Mailing Address - Fax:302-336-1075
Practice Address - Street 1:86 OMEGA DR
Practice Address - Street 2:OMEGA PROFESSIONAL CENTER, BUILDING B-86
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2065
Practice Address - Country:US
Practice Address - Phone:302-366-1929
Practice Address - Fax:302-366-1006
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT189845207R00000X
DEC10010412207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine