Provider Demographics
NPI:1710140926
Name:BHAVINI S CHANDARANA MD LLC
Entity Type:Organization
Organization Name:BHAVINI S CHANDARANA MD LLC
Other - Org Name:ADVANCED PHYSICAL MEDICINE & REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DR
Authorized Official - Prefix:
Authorized Official - First Name:BHAVINI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANDARANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-414-6499
Mailing Address - Street 1:420 ROUTE 34 STE 317
Mailing Address - Street 2:
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722-2517
Mailing Address - Country:US
Mailing Address - Phone:732-414-6499
Mailing Address - Fax:732-510-6499
Practice Address - Street 1:420 ROUTE 34 STE 317
Practice Address - Street 2:
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722-2517
Practice Address - Country:US
Practice Address - Phone:732-414-6499
Practice Address - Fax:844-890-8439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-08
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA078520002081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0089214Medicaid