Healthcare Provider Details

I. General information

NPI: 1750918710
Provider Name (Legal Business Name): ERIKA RAE KASTEN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIKA RAE KOLAKOWSKI DO

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

379 DIXMYTH AVE
CINCINNATI OH
45220-2475
US

IV. Provider business mailing address

379 DIXMYTH AVE
CINCINNATI OH
45220-2475
US

V. Phone/Fax

Practice location:
  • Phone: 513-246-7008
  • Fax: 513-246-7505
Mailing address:
  • Phone: 513-246-7008
  • Fax: 513-246-7505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number34.017389
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: