Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 35096178 | OH |
N | 207RA0201X | Internist - Allergy & Immunology | 35096178 | OH |
N | 2080P0201X | Pediatric Allergist | 35-096178 | OH |
NPI | 1700085164 |
---|---|
Provider Name | Rekha Priya Raveendran |
First Address | Chillicothe, OH 45601-9031 |
Second Address | Columbus, OH 43221-3502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2007 |
Last Update Date | 15/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0130815 | (05) | OH |