Provider Demographics
NPI:1578833547
Name:PANDEY, MANEESHA (MD)
Entity Type:Individual
Prefix:
First Name:MANEESHA
Middle Name:
Last Name:PANDEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2514 SPRUCE LOOP RD
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-8973
Mailing Address - Country:US
Mailing Address - Phone:419-481-1308
Mailing Address - Fax:
Practice Address - Street 1:2595 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-2673
Practice Address - Country:US
Practice Address - Phone:419-213-3900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.087746174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist