Provider Demographics
NPI:1164413266
Name:CHANDRAN, CHNADRA B (MD)
Entity Type:Individual
Prefix:DR
First Name:CHNADRA
Middle Name:B
Last Name:CHANDRAN
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 1:246 HAMBURG TPKE
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2150
Mailing Address - Country:US
Mailing Address - Phone:973-653-3366
Mailing Address - Fax:973-653-3365
Practice Address - Street 1:246 HAMBURG TPKE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2150
Practice Address - Country:US
Practice Address - Phone:973-653-3366
Practice Address - Fax:973-653-3365
Is Sole Proprietor?:No
Enumeration Date:2005-10-30
Last Update Date:2008-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA34612207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ221963249OtherQUALCARE
NJ4300278OtherAETNA
NJ36285OtherAMERIGROUP
NJ088605Medicaid
NJ91000306600OtherAMERICHOICE
NJ1348622OtherUNITED HC
NJCC8414OtherRAILROAD MEDICARE
NJP2022052OtherOXFORD
NJ1042675OtherHORIZON NJ HEALTH
NJ8215827OtherGHI
NJ0713629OtherCIGNA
NJ1K6888OtherHEALTHNET
NJ0072037000OtherAMERIHEALTH
NJ8215827OtherGHI
NJ404129Medicare PIN