Provider Demographics
NPI:1386878981
Name:CHANDUVI, VICTOR C (ST/SA)
Entity type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:C
Last Name:CHANDUVI
Suffix:
Gender:M
Credentials:ST/SA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 JAN CT
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07407-2724
Mailing Address - Country:US
Mailing Address - Phone:973-405-1745
Mailing Address - Fax:
Practice Address - Street 1:9 JAN CT
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07407-2724
Practice Address - Country:US
Practice Address - Phone:973-405-1745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant