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General NPI Number Information
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NPI Number | 1700134095
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Entity Type | Organization
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Legal Business Name | SRI RAYANI LLC
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Dates
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Enumeration Date | 08/17/2012
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Last Update Date | 08/17/2012
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Provider Practice Location Address
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Address Line | 462 PINEVIEW DR
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City | GALLIPOLIS
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State | OH
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Zip | 45631-9038
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Country | US
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Telephone | 740-710-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 462 PINEVIEW DR
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City | GALLIPOLIS
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State | OH
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Zip | 45631-9038
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Country | US
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Telephone | 740-710-3100
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | SUJANA RAYANI
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Credential | MD
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Telephone | 740-710-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number | 35093820
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License Number State | OH
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