Provider Demographics
NPI:1841347341
Name:PARTHASARATHY, TERALANDUR K (PHD)
Entity type:Individual
Prefix:MR
First Name:TERALANDUR
Middle Name:K
Last Name:PARTHASARATHY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:#30 RONNIE'S PLAZA
Mailing Address - Street 2:
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63126
Mailing Address - Country:US
Mailing Address - Phone:866-696-5958
Mailing Address - Fax:618-288-2084
Practice Address - Street 1:#30 RONNIE'S PLAZA
Practice Address - Street 2:
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63126
Practice Address - Country:US
Practice Address - Phone:866-696-5958
Practice Address - Fax:618-288-2084
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01636231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOMA1409Medicare PIN