Provider Demographics
NPI:1063619542
Name:CHANDER ROLAND, BANI (MD)
Entity type:Individual
Prefix:DR
First Name:BANI
Middle Name:
Last Name:CHANDER ROLAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BANI
Other - Middle Name:
Other - Last Name:CHANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:161 FT WASHINGTN AVE
Mailing Address - Street 2:SUITE 862
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3729
Mailing Address - Country:US
Mailing Address - Phone:917-692-6745
Mailing Address - Fax:
Practice Address - Street 1:161 FT WASHINGTN AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3729
Practice Address - Country:US
Practice Address - Phone:212-305-1021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0070529207RG0100X
MDD74626207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD59637000Medicaid
MD256618ZAEMMedicare PIN