Provider Demographics
NPI:1114153764
Name:MARATHE, KALYANI SHRIRAM (MD, MPH)
Entity Type:Individual
Prefix:
First Name:KALYANI
Middle Name:SHRIRAM
Last Name:MARATHE
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:KALYANI
Other - Middle Name:MARATHE
Other - Last Name:RAUCCI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3333 BURNET AVE
Mailing Address - Street 2:ML 3004
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229
Mailing Address - Country:US
Mailing Address - Phone:513-636-4215
Mailing Address - Fax:513-636-5867
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:ML 3004
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229
Practice Address - Country:US
Practice Address - Phone:513-636-4215
Practice Address - Fax:513-636-5867
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.136659207NP0225X
DCMD042609207NP0225X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology