Basic Information
| Provider Information | |||||||||
| NPI: | 1073684403 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PRITI NAIR, M.D., INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19645 PROGRESS DR | ||||||||
| Address2: | |||||||||
| City: | STRONGSVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441493205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4402348833 | ||||||||
| FaxNumber: | 4402343313 | ||||||||
| Practice Location | |||||||||
| Address1: | 1991 CROCKER RD TWR 1 STE 600 | ||||||||
| Address2: | |||||||||
| City: | WESTLAKE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44145 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4406107104 | ||||||||
| FaxNumber: | 4403065566 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2006 | ||||||||
| LastUpdateDate: | 05/05/2022 | ||||||||
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| AuthorizedOfficialLastName: | NAIR | ||||||||
| AuthorizedOfficialFirstName: | PRITI | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER-PROVIDER | ||||||||
| AuthorizedOfficialTelephone: | 4406107104 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | 05/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 35073559 | OH | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | DG1837 | 01 | OH | RAILROAD MEDICARE | OTHER | 2857592 | 05 | OH | MEDICAID |