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General NPI Number Information
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NPI Number | 1831103795
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Entity Type | Organization
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Legal Business Name | TRI-STATE REGIONAL CANCER CENTER
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 07/21/2015
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Provider Practice Location Address
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Address Line | 15898 SAINT CLAIR AVE
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City | EAST LIVERPOOL
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State | OH
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Zip | 43920-9122
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Country | US
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Telephone | 330-385-0404
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 200
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City | EAST LIVERPOOL
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State | OH
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Zip | 43920-5200
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Country | US
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Telephone | 330-385-0404
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RANJAN P BHANDARI
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Credential | MD
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Telephone | 330-385-0404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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