Provider Demographics
NPI:1548442031
Name:SANDRU, DAN VICTOR (MD)
Entity type:Individual
Prefix:DR
First Name:DAN
Middle Name:VICTOR
Last Name:SANDRU
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:389 N COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-4426
Mailing Address - Country:US
Mailing Address - Phone:732-987-5111
Mailing Address - Fax:732-987-5109
Practice Address - Street 1:389 N COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-4426
Practice Address - Country:US
Practice Address - Phone:732-987-5111
Practice Address - Fax:732-987-5109
Is Sole Proprietor?:No
Enumeration Date:2007-11-27
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08439200207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine