Provider Demographics
NPI:1669286183
Name:RASAILY, CHANDRA WOTI
Entity type:Individual
Prefix:
First Name:CHANDRA
Middle Name:WOTI
Last Name:RASAILY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2181 VICTORY PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-2907
Mailing Address - Country:US
Mailing Address - Phone:513-574-1500
Mailing Address - Fax:216-760-1985
Practice Address - Street 1:2181 VICTORY PKWY STE 101
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-2907
Practice Address - Country:US
Practice Address - Phone:513-574-1500
Practice Address - Fax:216-760-1985
Is Sole Proprietor?:No
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator