Provider Demographics
NPI:1609224625
Name:MASIH, SANDHYA T (DO)
Entity Type:Individual
Prefix:
First Name:SANDHYA
Middle Name:T
Last Name:MASIH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:SANDHYA
Other - Middle Name:
Other - Last Name:TALLURI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:2 N CENTRAL AVE STE 1800
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-2139
Mailing Address - Country:US
Mailing Address - Phone:480-326-8997
Mailing Address - Fax:
Practice Address - Street 1:2 N CENTRAL AVE STE 1800
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-2139
Practice Address - Country:US
Practice Address - Phone:480-326-8997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A185492084P0800X
AZR26702084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry