Healthcare Provider Details

I. General information

NPI: 1003854050
Provider Name (Legal Business Name): R.CHANDRA, M.D.,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 12/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1517 FOX CHASE LN
PITTSBURGH PA
15241-3147
US

IV. Provider business mailing address

1517 FOX CHASE LN
PITTSBURGH PA
15241-3147
US

V. Phone/Fax

Practice location:
  • Phone: 412-519-4064
  • Fax: 412-257-5137
Mailing address:
  • Phone: 412-257-2040
  • Fax: 412-257-5137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. USHA RANI CHANDRA
Title or Position: ADMINISTRATOR
Credential:
Phone: 412-257-2040