Provider Demographics
NPI:1912069659
Name:ABI'S CLINIC LTD.
Entity Type:Organization
Organization Name:ABI'S CLINIC LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:LACHMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABICHANDANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-894-6484
Mailing Address - Street 1:9200 WATSON RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63126-1528
Mailing Address - Country:US
Mailing Address - Phone:314-894-6484
Mailing Address - Fax:314-894-8070
Practice Address - Street 1:9200 WATSON RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63126-1528
Practice Address - Country:US
Practice Address - Phone:314-894-6484
Practice Address - Fax:314-894-8070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR93022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOB18372Medicare UPIN