Provider Demographics
NPI:1417906678
Name:SACHAN, PAVAN K (MD)
Entity Type:Individual
Prefix:
First Name:PAVAN
Middle Name:K
Last Name:SACHAN
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 1:695 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-9302
Mailing Address - Country:US
Mailing Address - Phone:908-688-6565
Mailing Address - Fax:908-688-3161
Practice Address - Street 1:695 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-9302
Practice Address - Country:US
Practice Address - Phone:908-688-6565
Practice Address - Fax:908-688-3161
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ66847207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8230307Medicaid
NJ2546487OtherAETNA
NJ2K8650OtherHEALTHNET
NJP2117167OtherOXFORD
NJ2K8650OtherHEALTHNET
NJ8230307Medicaid