Healthcare Provider Details

I. General information

NPI: 1447470281
Provider Name (Legal Business Name): NANDINI KHOSLA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7654 MONTGOMERY RD
CINCINNATI OH
45236-4204
US

IV. Provider business mailing address

7654 MONTGOMERY RD
CINCINNATI OH
45236-4204
US

V. Phone/Fax

Practice location:
  • Phone: 513-791-1691
  • Fax: 513-791-8873
Mailing address:
  • Phone: 513-791-1691
  • Fax: 513-791-8873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number47426
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: