Provider Demographics
NPI:1053561654
Name:SANKHOLKAR, KEDAR (MD, MS)
Entity type:Individual
Prefix:
First Name:KEDAR
Middle Name:
Last Name:SANKHOLKAR
Suffix:
Gender:M
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 CLIFTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-3522
Mailing Address - Country:US
Mailing Address - Phone:973-778-3777
Mailing Address - Fax:973-778-3252
Practice Address - Street 1:1030 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3522
Practice Address - Country:US
Practice Address - Phone:973-778-3777
Practice Address - Fax:973-778-3252
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-19
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09524700207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease