Chandragiri, Sanjay

Chandragiri, Sanjay is an sole proprietor health care provider with primary practice located at 1141 Clay Ave Ste 2 , Dunmore PA 18510-1191. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychosomatic Medicine, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Chandragiri, Sanjay can be contacted via phone (570) 207-7919.

Contact Information

Primary practice address
1141 Clay Ave Ste 2 Dunmore PA 18510-1191
Phone: (570) 207-7919
Fax: (570) 963-1953
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychosomatic Medicine 2084P0015X MD065361L Pennsylvania
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X MD065361L Pennsylvania

Profile Details

NPI number 1467433060
LBN Legal business name Chandragiri, Sanjay
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 10th, 2005
Last updated Mar 15th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467433060 NPPES
Pennsylvania MEDICAID 001709170003

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