Provider Demographics
NPI:1700053592
Name:CHANDWANI, ASHISH (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHISH
Middle Name:
Last Name:CHANDWANI
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:PO BOX 300
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-0300
Mailing Address - Country:US
Mailing Address - Phone:973-538-5844
Mailing Address - Fax:
Practice Address - Street 1:220 RIDGEDALE AVE
Practice Address - Street 2:SUITE C2
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1361
Practice Address - Country:US
Practice Address - Phone:973-538-5844
Practice Address - Fax:973-538-3650
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY240501207RI0200X
PAMD433997207RI0200X
NJ25MA08420800207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJMA0842080OtherLICENSE