Provider Demographics
NPI:1104665603
Name:NANDY, ARJUN S
Entity type:Individual
Prefix:
First Name:ARJUN
Middle Name:S
Last Name:NANDY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 S FEDERAL ST UNIT E
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-3373
Mailing Address - Country:US
Mailing Address - Phone:312-607-4404
Mailing Address - Fax:
Practice Address - Street 1:1206 S FEDERAL ST UNIT E
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-3373
Practice Address - Country:US
Practice Address - Phone:312-607-4404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty