Provider Demographics
NPI:1508826991
Name:SANJAY, BRINDA (MD)
Entity Type:Individual
Prefix:
First Name:BRINDA
Middle Name:
Last Name:SANJAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 BELMONT ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-1019
Mailing Address - Country:US
Mailing Address - Phone:508-425-2500
Mailing Address - Fax:508-425-2600
Practice Address - Street 1:403 BELMONT ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-1019
Practice Address - Country:US
Practice Address - Phone:508-424-2500
Practice Address - Fax:508-425-2600
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA159986207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0034991OtherCIGNA HEALTH PLAN
784182OtherMVP HEALTH CARE
0177351OtherWELFARE
042472266OtherONE HEALTH PLAN
54418OtherFALLON COMMUNITY HEALTH P
7890078OtherAETNA US HEALTHCARE
J25289OtherBLUE CARE ELECT
J25289OtherBLUE SHIELD INDEMNITY
MA0177351Medicaid
042472266OtherPRIVATE HEALTHCARE SYSTEM
J25289OtherBLUE SHIELD HMO BLUE
0404128OtherEVERCARE
042472266OtherTHREE RIVERS
042472266012OtherTRICARE CHAMPUS
2015758OtherFIRST HEALTH
AA1286OtherHARVARD PILGRIM HEALTHCAR
J25289OtherBLUE SHIELD INDEMNITY
7890078OtherAETNA US HEALTHCARE
0034991OtherCIGNA HEALTH PLAN
J25289OtherBLUE CARE ELECT
H11510Medicare UPIN