Healthcare Provider Details

I. General information

NPI: 1750568200
Provider Name (Legal Business Name): TINA RAKKHIT NANDI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2008
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1407 YORK RD STE 100A
LUTHERVILLE MD
21093-6077
US

IV. Provider business mailing address

1407 YORK RD STE 100A
LUTHERVILLE MD
21093-6077
US

V. Phone/Fax

Practice location:
  • Phone: 410-252-9090
  • Fax:
Mailing address:
  • Phone: 410-252-9090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberD88261
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number247216
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: