Provider Demographics
NPI:1649032392
Name:ODARI, MAHENDRA
Entity type:Individual
Prefix:
First Name:MAHENDRA
Middle Name:
Last Name:ODARI
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 1:526 E BRUCETON RD STE 110A
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236-4677
Mailing Address - Country:US
Mailing Address - Phone:469-235-0302
Mailing Address - Fax:
Practice Address - Street 1:526 E BRUCETON RD STE 110A
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236-4677
Practice Address - Country:US
Practice Address - Phone:469-235-0302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA921203340Medicaid