Provider Demographics
NPI:1437109741
Name:BHARGAVA, SANDEEP (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDEEP
Middle Name:
Last Name:BHARGAVA
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 1:1100 WESCOTT DR STE 304
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-4600
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:856-355-0330
Practice Address - Street 1:217 WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:HADDON HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08035-1703
Practice Address - Country:US
Practice Address - Phone:856-547-1212
Practice Address - Fax:856-547-3722
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA77239207RG0100X
NJ25MA07723900207RT0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RT0003XAllopathic & Osteopathic PhysiciansInternal MedicineTransplant Hepatology
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ00556413Medicaid
NJ00556413Medicaid
NJH32395Medicare UPIN