Provider Demographics
NPI:1043327000
Name:CHANDRASEKARAN, KULANDAIVELU (MD)
Entity type:Individual
Prefix:MR
First Name:KULANDAIVELU
Middle Name:
Last Name:CHANDRASEKARAN
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 1:1400 RACHEL TERRACE
Mailing Address - Street 2:APT 16
Mailing Address - City:PINEBROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07058-9309
Mailing Address - Country:US
Mailing Address - Phone:973-439-7273
Mailing Address - Fax:
Practice Address - Street 1:385 TREMONT AVE STE 9-167 MSC 111
Practice Address - Street 2:VETERANS AFFAIRS MEDICAL CENTER
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-1023
Practice Address - Country:US
Practice Address - Phone:973-676-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05956600207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease