Provider Demographics
NPI:1679905004
Name:KANDARE, JOHN E (AUD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:KANDARE
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 E. WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44022-4447
Mailing Address - Country:US
Mailing Address - Phone:440-247-9999
Mailing Address - Fax:
Practice Address - Street 1:512 EAST WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44022-4447
Practice Address - Country:US
Practice Address - Phone:440-247-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-08
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201001513231H00000X
OHA.01903231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist