Provider Demographics
NPI:1902826589
Name:CHANDARANA, BHAVINI S (MD)
Entity Type:Individual
Prefix:DR
First Name:BHAVINI
Middle Name:S
Last Name:CHANDARANA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 69
Mailing Address - Street 2:
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722-0069
Mailing Address - Country:US
Mailing Address - Phone:732-414-6499
Mailing Address - Fax:844-890-8439
Practice Address - Street 1:315 ROUTE 34 STE 135
Practice Address - Street 2:
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722-2444
Practice Address - Country:US
Practice Address - Phone:732-414-6499
Practice Address - Fax:844-890-8439
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA078520002081P2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0089214Medicaid
NJP01924026OtherMEDICARE RAILROAD
NJ096153ZFCCOtherMEDICARE PTAN
H71170Medicare UPIN