Provider Demographics
NPI:1770519944
Name:BHENDWAL, SANJAY KUMAR (MD)
Entity type:Individual
Prefix:DR
First Name:SANJAY
Middle Name:KUMAR
Last Name:BHENDWAL
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 W SHERMAN AVE STE 1B
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-6931
Mailing Address - Country:US
Mailing Address - Phone:856-692-7700
Mailing Address - Fax:856-213-5825
Practice Address - Street 1:1051 W SHERMAN AVE STE 1B
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-6931
Practice Address - Country:US
Practice Address - Phone:856-692-7700
Practice Address - Fax:856-213-5825
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA67560207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7865902Medicaid
NJG82004Medicare UPIN
NJ7865902Medicaid