Provider Demographics
NPI:1871594283
Name:RANA, SANDEEP S (MD)
Entity type:Individual
Prefix:
First Name:SANDEEP
Middle Name:S
Last Name:RANA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:490 E NORTH AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4765
Mailing Address - Country:US
Mailing Address - Phone:412-359-8850
Mailing Address - Fax:412-359-8809
Practice Address - Street 1:490 E NORTH AVE STE 500
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4765
Practice Address - Country:US
Practice Address - Phone:412-359-8850
Practice Address - Fax:412-359-8809
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD055155L2084N0400X, 2084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001549237Medicaid
10934614OtherCAQH
PA001549237Medicaid
791539Medicare PIN
PA0015492370008Medicaid
PA0015492370003Medicaid