Provider Demographics
NPI:1992930044
Name:SADANANTHAM, CHANDRA V (PT)
Entity type:Individual
Prefix:MS
First Name:CHANDRA
Middle Name:V
Last Name:SADANANTHAM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 VILLAGE GATE WAY
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-1548
Mailing Address - Country:US
Mailing Address - Phone:845-782-0071
Mailing Address - Fax:845-782-0071
Practice Address - Street 1:14 VILLAGE GATE WAY
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-1548
Practice Address - Country:US
Practice Address - Phone:845-782-0071
Practice Address - Fax:845-782-0071
Is Sole Proprietor?:No
Enumeration Date:2009-05-19
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017140225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist