Provider Demographics
NPI:1922382571
Name:CHANDER MOHAN M D INC
Entity Type:Organization
Organization Name:CHANDER MOHAN M D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIEDEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-929-9794
Mailing Address - Street 1:275 GRAHAM RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44223-2203
Mailing Address - Country:US
Mailing Address - Phone:330-929-9794
Mailing Address - Fax:330-929-9850
Practice Address - Street 1:275 GRAHAM RD
Practice Address - Street 2:SUITE 5
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223-2203
Practice Address - Country:US
Practice Address - Phone:330-929-9794
Practice Address - Fax:330-929-9850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC-0002928101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty