Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 25MA08247200 | NJ |
NPI | 1194920637 |
---|---|
Provider Name | Tarun Bhandari |
First Address | Brick, NJ 08723-6077 |
Second Address | Brick, NJ 08723-6077 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2007 |
Last Update Date | 22/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0159794 | (05) | NJ |
ZE1773 | HEALTHNET (01) | NJ |