Provider Demographics
NPI:1225009640
Name:RAMCHANDANI, SANJAY MOHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SANJAY
Middle Name:MOHAN
Last Name:RAMCHANDANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SANJAY
Other - Middle Name:MOHAN
Other - Last Name:RAMCHANDANI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:145 HOSPITAL AVE
Mailing Address - Street 2:SUITE 315
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-1462
Mailing Address - Country:US
Mailing Address - Phone:814-371-6721
Mailing Address - Fax:814-371-3921
Practice Address - Street 1:145 HOSPITAL AVE
Practice Address - Street 2:SUITE 315
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-1462
Practice Address - Country:US
Practice Address - Phone:814-371-6721
Practice Address - Fax:814-371-3921
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5107207VM0101X
PAMD073392L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA369529OtherMEDICARE PTAN
TX151866402Medicaid
PA10296982Medicaid
TX8D4761Medicare ID - Type Unspecified
PA10296982Medicaid