Provider Demographics
NPI:1487652293
Name:NAGI, CHANDANDEEP S (MD)
Entity type:Individual
Prefix:
First Name:CHANDANDEEP
Middle Name:S
Last Name:NAGI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:1 GUSTAVE L LEVY PL
Mailing Address - Street 2:PATHOLOGY, BOX 1194
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6500
Mailing Address - Country:US
Mailing Address - Phone:212-731-7771
Mailing Address - Fax:212-534-7491
Practice Address - Street 1:1 GUSTAVE L LEVY PL
Practice Address - Street 2:ANNENBERG 15TH FLOOR ROOM 29
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6500
Practice Address - Country:US
Practice Address - Phone:212-241-1632
Practice Address - Fax:212-534-7491
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2014-05-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXP8393207ZP0102X
NY231381-1207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY56R561Medicare ID - Type Unspecified
NYI10161Medicare UPIN