Healthcare Provider Details

I. General information

NPI: 1518466655
Provider Name (Legal Business Name): PREETI BANSAL KSHIRSAGAR MPH, RDN, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. PREETI BANSAL

II. Dates (important events)

Enumeration Date: 02/05/2018
Last Update Date: 11/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3536 EDWARDS RD STE 210
CINCINNATI OH
45208
US

IV. Provider business mailing address

3536 EDWARDS RD STE 210
CINCINNATI OH
45208-1358
US

V. Phone/Fax

Practice location:
  • Phone: 513-788-3953
  • Fax:
Mailing address:
  • Phone: 513-506-2868
  • Fax: 513-986-5047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License NumberLD.08450
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLD.08450
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: