Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207NS0135X | Procedural Dermatology | 25MA05286200 | NJ |
Y | 208200000X | Surgeon | 25MA05286200 | NJ |
Y | 208600000X | Surgeon | 25MA05286200 | NJ |
NPI | 1255458105 |
---|---|
Provider Name | Dr. Baldev Singh Sandhu |
First Address | Englewood Cliffs, NJ 07632-1828 |
Second Address | Englewood Cliffs, NJ 07632-1828 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2007 |
Last Update Date | 21/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D91863 | (02) | NJ |