Provider Demographics
NPI:1326285370
Name:USHARANI V TANDRA MD INC
Entity Type:Organization
Organization Name:USHARANI V TANDRA MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:USHARANI
Authorized Official - Middle Name:V
Authorized Official - Last Name:TANDRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-352-6132
Mailing Address - Street 1:1610 MENTOR AVE
Mailing Address - Street 2:STE 2
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-1744
Mailing Address - Country:US
Mailing Address - Phone:440-352-6132
Mailing Address - Fax:440-392-6193
Practice Address - Street 1:1610 MENTOR AVE
Practice Address - Street 2:STE 2
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-1744
Practice Address - Country:US
Practice Address - Phone:440-352-6132
Practice Address - Fax:440-392-6193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-13
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty