Provider Demographics
NPI:1063501609
Name:SAMBANDAN, RAMA T (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMA
Middle Name:T
Last Name:SAMBANDAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 HAZLET AVE
Mailing Address - Street 2:#5
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730
Mailing Address - Country:US
Mailing Address - Phone:732-264-5253
Mailing Address - Fax:732-335-9768
Practice Address - Street 1:80 HAZLET AVE
Practice Address - Street 2:#5
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730
Practice Address - Country:US
Practice Address - Phone:732-264-5253
Practice Address - Fax:732-335-9768
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA49570207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E15306Medicare UPIN
550588Medicare ID - Type Unspecified