Basic Information
Provider Information
NPI: 1265728489
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KALARIA
FirstName: CHANDNI
MiddleName: PANKAJ
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: PATEL
OtherFirstName: CHANDNI
OtherMiddleName: PANKAJ
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 1540 SUNDAY DR
Address2:  
City: RALEIGH
State: NC
PostalCode: 276076010
CountryCode: US
TelephoneNumber: 9197823456
FaxNumber: 9197831441
Practice Location
Address1: 1540 SUNDAY DR
Address2:  
City: RALEIGH
State: NC
PostalCode: 27607
CountryCode: US
TelephoneNumber: 9197823456
FaxNumber: 9197831441
Other Information
ProviderEnumerationDate: 06/27/2011
LastUpdateDate: 08/15/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084V0102XMD044090DCN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
2084N0400X2019-00969NCY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology

No ID Information.


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