Provider Demographics
NPI:1790424869
Name:UTTAM CHANDANI, KANISHKA (MD)
Entity Type:Individual
Prefix:
First Name:KANISHKA
Middle Name:
Last Name:UTTAM CHANDANI
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 1:115 CASS AVE.
Mailing Address - Street 2:LANDMARK MEDICAL CENTER
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895
Mailing Address - Country:US
Mailing Address - Phone:401-769-4100
Mailing Address - Fax:401-767-1674
Practice Address - Street 1:115 CASS AVE
Practice Address - Street 2:LANDMARK MEDICAL CENTER
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895
Practice Address - Country:US
Practice Address - Phone:401-769-4100
Practice Address - Fax:401-767-1674
Is Sole Proprietor?:No
Enumeration Date:2022-05-27
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program