Provider Demographics
NPI:1649246760
Name:ANAND, CHETAN (MD)
Entity type:Individual
Prefix:
First Name:CHETAN
Middle Name:
Last Name:ANAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:CHETAN
Other - Middle Name:
Other - Last Name:MALIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:120 JANWICH DR
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-1479
Mailing Address - Country:US
Mailing Address - Phone:585-295-8554
Mailing Address - Fax:877-515-3114
Practice Address - Street 1:180 WHITE RD STE 204
Practice Address - Street 2:
Practice Address - City:LITTLE SILVER
Practice Address - State:NJ
Practice Address - Zip Code:07739-1166
Practice Address - Country:US
Practice Address - Phone:732-889-3310
Practice Address - Fax:877-515-3114
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY258156208100000X, 2081P2900X, 208VP0014X
NJ25MA09574100208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02594269Medicaid
NY258156-9WOtherWORKERS COMP
NYRA4642Medicare PIN
NYJ400023282Medicare PIN
NY258156-9WOtherWORKERS COMP
NYJ400019477Medicare PIN