Healthcare Provider Details

I. General information

NPI: 1033143722
Provider Name (Legal Business Name): RAKESH RANJAN M.D. & ASSOC., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 E WASHINGTON ST SUITE 150
MEDINA OH
44256-3335
US

IV. Provider business mailing address

12395 MCCRACKEN RD STE H
CLEVELAND OH
44125-2946
US

V. Phone/Fax

Practice location:
  • Phone: 330-722-1069
  • Fax: 330-764-9712
Mailing address:
  • Phone: 216-587-6727
  • Fax: 866-277-0869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE A KELLY
Title or Position: CREDENTIALING
Credential:
Phone: 162-587-6727