Provider Demographics
NPI:1780489807
Name:RASAILY, CHANDRA BIR
Entity type:Individual
Prefix:
First Name:CHANDRA
Middle Name:BIR
Last Name:RASAILY
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 1:9202 SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68122-3046
Mailing Address - Country:US
Mailing Address - Phone:402-504-6570
Mailing Address - Fax:402-619-5508
Practice Address - Street 1:1551 N 18TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68110-2418
Practice Address - Country:US
Practice Address - Phone:402-594-8866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide