Healthcare Provider Details

I. General information

NPI: 1841775327
Provider Name (Legal Business Name): RASANJANA BHANDARI EDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2018
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10320 COTTONWOOD PARK NW STE A
ALBUQUERQUE NM
87114-7008
US

IV. Provider business mailing address

4735 LEON GRANDE AVE SE
RIO RANCHO NM
87124-1302
US

V. Phone/Fax

Practice location:
  • Phone: 505-250-5204
  • Fax:
Mailing address:
  • Phone: 603-247-8472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number393295
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: