Individual
SANJEEV DATTATRAYA ATHALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 COOPER PLZ, CAMDEN, NJ 08103-1461
(856) 342-2380
Mailing address
1 FEDERAL ST STE 200, CAMDEN, NJ 08103-1088
(482) 886-9358
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
233479
NY
2085N0904X
Nuclear Radiology Physician
A114198
CA
2085R0202X
Diagnostic Radiology Physician
Primary
25MA11615900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407836935
—
CA
Enumeration date
01/19/2006
Last updated
04/27/2026
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