Provider Demographics
NPI:1881689396
Name:SANDHU, FATEJEET S (MD)
Entity Type:Individual
Prefix:DR
First Name:FATEJEET
Middle Name:S
Last Name:SANDHU
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 1:36 TAMARACK AVE, PMB 118
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811
Mailing Address - Country:US
Mailing Address - Phone:203-739-7532
Mailing Address - Fax:203-796-7667
Practice Address - Street 1:24 HOSPITAL AVE
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6099
Practice Address - Country:US
Practice Address - Phone:203-739-7532
Practice Address - Fax:203-796-7667
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0403202085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP00154494Medicare PIN
CT300003329Medicare PIN
E96985Medicare UPIN
CT300003613Medicare PIN
NY619T41Medicare PIN
CTP00051462Medicare PIN