Provider Demographics
NPI:1629324405
Name:RAMAN BAISHNAB DO INC
Entity Type:Organization
Organization Name:RAMAN BAISHNAB DO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:MACHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GIORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-723-2111
Mailing Address - Street 1:10900 PEARL RD
Mailing Address - Street 2:STE C-1
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-3349
Mailing Address - Country:US
Mailing Address - Phone:440-268-8422
Mailing Address - Fax:440-268-8420
Practice Address - Street 1:10900 PEARL RD
Practice Address - Street 2:STE C-1
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-3349
Practice Address - Country:US
Practice Address - Phone:440-268-8422
Practice Address - Fax:440-268-8420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH340100012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty