Provider Demographics
NPI:1447470281
Name:KHOSLA, NANDINI (MD)
Entity type:Individual
Prefix:
First Name:NANDINI
Middle Name:
Last Name:KHOSLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7654 MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-4204
Mailing Address - Country:US
Mailing Address - Phone:513-791-1691
Mailing Address - Fax:513-791-8873
Practice Address - Street 1:7654 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-4204
Practice Address - Country:US
Practice Address - Phone:513-791-1691
Practice Address - Fax:513-791-8873
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH474262084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHKH0542861Medicare ID - Type Unspecified