Individual
JAYASREE JAYADEVAN NANDAGOPAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7760 UNIVERSITY CT, SUITE H, WEST CHESTER, OH 45069-3371
(513) 547-4491
Mailing address
2070 WINDING CREEK LN, MASON, OH 45040-1451
(513) 868-1562
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
35.088216
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000663376
ANTHEM
OH
01
—
1215072301
ALLIANCE SELECT
OH
01
—
272314123
LIFESYNCH - HUMANA
OH
05
—
2726054
—
OH
Enumeration date
02/20/2007
Last updated
03/07/2023
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