Provider Demographics
NPI:1689340796
Name:SACHDEV, KELLY
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:SACHDEV
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 E 86TH ST APT 1205
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-3021
Mailing Address - Country:US
Mailing Address - Phone:619-952-6866
Mailing Address - Fax:
Practice Address - Street 1:516 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-4514
Practice Address - Country:US
Practice Address - Phone:929-523-0259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-18
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program