Provider Demographics
NPI:1518466655
Name:BANSAL KSHIRSAGAR, PREETI (MPH, RDN, LD)
Entity Type:Individual
Prefix:MS
First Name:PREETI
Middle Name:
Last Name:BANSAL KSHIRSAGAR
Suffix:
Gender:F
Credentials:MPH, RDN, LD
Other - Prefix:MS
Other - First Name:PREETI
Other - Middle Name:
Other - Last Name:BANSAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3536 EDWARDS RD STE 210
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-1358
Mailing Address - Country:US
Mailing Address - Phone:513-506-2868
Mailing Address - Fax:513-986-5047
Practice Address - Street 1:3536 EDWARDS RD STE 210
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45208
Practice Address - Country:US
Practice Address - Phone:513-788-3953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-05
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.08450133VN1006X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic