Basic Information
| Provider Information | |||||||||
| NPI: | 1205928959 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KAKAR | ||||||||
| FirstName: | PRIYANKA | ||||||||
| MiddleName: | |||||||||
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| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 10475 READING RD STE 405 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452412500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135859600 | ||||||||
| FaxNumber: | 5135859668 | ||||||||
| Practice Location | |||||||||
| Address1: | 10475 READING RD STE 405 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452412500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135859600 | ||||||||
| FaxNumber: | 5135859668 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/29/2006 | ||||||||
| LastUpdateDate: | 09/12/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 01066595 | IN | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 35.137258 | OH | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 200959030 | 05 | IN | MEDICAID |