Healthcare Provider Details

I. General information

NPI: 1336079607
Provider Name (Legal Business Name): KUNDAN JHA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30952 PRESTWICK XING
WESTLAKE OH
44145-5090
US

IV. Provider business mailing address

30952 PRESTWICK XING
WESTLAKE OH
44145-5090
US

V. Phone/Fax

Practice location:
  • Phone: 216-801-1015
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: