Provider Demographics
NPI:1164453775
Name:NAIR, CHAND JAYAN (MD)
Entity type:Individual
Prefix:
First Name:CHAND
Middle Name:JAYAN
Last Name:NAIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 ANTHONY DR
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1040
Mailing Address - Country:US
Mailing Address - Phone:610-832-1070
Mailing Address - Fax:
Practice Address - Street 1:7170 LAFAYETTE AVE
Practice Address - Street 2:BROOKE GLEN BEHAVIORAL HOSPITAL
Practice Address - City:FORT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-2301
Practice Address - Country:US
Practice Address - Phone:213-641-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 4176172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA60734Medicare UPIN