Provider Demographics
NPI:1255993747
Name:GHANDI, TETTEH ABREDU
Entity type:Individual
Prefix:
First Name:TETTEH
Middle Name:ABREDU
Last Name:GHANDI
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 1:7671 CENTRAL AVE NE
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-3575
Mailing Address - Country:US
Mailing Address - Phone:952-484-0260
Mailing Address - Fax:
Practice Address - Street 1:9823 QUINCY ST NE
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55434-2560
Practice Address - Country:US
Practice Address - Phone:952-484-0260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-03
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health