Provider Demographics
NPI:1801047220
Name:JAGAMONY, SANDHYA (MD)
Entity type:Individual
Prefix:DR
First Name:SANDHYA
Middle Name:
Last Name:JAGAMONY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JAGAMONY
Other - Middle Name:
Other - Last Name:SANDHYA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:93 ROANOKE ST
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07095-2536
Mailing Address - Country:US
Mailing Address - Phone:732-986-6753
Mailing Address - Fax:
Practice Address - Street 1:93 ROANOKE ST
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07095-2536
Practice Address - Country:US
Practice Address - Phone:732-207-7113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-03
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08478200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine