Provider Demographics
NPI:1649981283
Name:CHAND, AMIT KUMAR
Entity type:Individual
Prefix:
First Name:AMIT
Middle Name:KUMAR
Last Name:CHAND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 S MAIN ST STE 14
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:NJ
Mailing Address - Zip Code:07644-2235
Mailing Address - Country:US
Mailing Address - Phone:551-255-6012
Mailing Address - Fax:
Practice Address - Street 1:1005 MANHATTAN AVE APT 2R
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-6541
Practice Address - Country:US
Practice Address - Phone:718-669-4945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-05
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY88-3111118Medicaid