Healthcare Provider Details

I. General information

NPI: 1184588428
Provider Name (Legal Business Name): PRANALI SURESH AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 MACARTHUR BLVD
MUNSTER IN
46321-2901
US

IV. Provider business mailing address

9600 HAMPTON DR APT 13
HIGHLAND IN
46322-2447
US

V. Phone/Fax

Practice location:
  • Phone: 219-703-2460
  • Fax: 219-703-6776
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number23002940A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: