Provider Demographics
NPI:1417936824
Name:SELL, NEELAM KHAROD (MD)
Entity Type:Individual
Prefix:DR
First Name:NEELAM
Middle Name:KHAROD
Last Name:SELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:65 MECHANIC ST STE L-3
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1868
Mailing Address - Country:US
Mailing Address - Phone:732-345-8380
Mailing Address - Fax:732-345-8381
Practice Address - Street 1:65 MECHANIC ST STE L-3
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1868
Practice Address - Country:US
Practice Address - Phone:732-345-8380
Practice Address - Fax:732-345-8381
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07695400208000000X, 2080P0006X
PAMD4337832080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0071111Medicaid