Provider Demographics
NPI:1154663300
Name:SALUJA, SANDEEP SINGH (MD)
Entity Type:Individual
Prefix:
First Name:SANDEEP
Middle Name:SINGH
Last Name:SALUJA
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 1:15-01 BROADWAY STE 38
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-6026
Mailing Address - Country:US
Mailing Address - Phone:201-623-9438
Mailing Address - Fax:
Practice Address - Street 1:15-01 BROADWAY STE 38
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-6026
Practice Address - Country:US
Practice Address - Phone:201-623-9438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-25
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA269800207N00000X
390200000X
CT60371207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program