Provider Demographics
NPI:1609010909
Name:KOTHARI, PARUL A (RD)
Entity Type:Individual
Prefix:
First Name:PARUL
Middle Name:A
Last Name:KOTHARI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 BURNET AVE
Mailing Address - Street 2:5 RIDGEWAY
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3019
Mailing Address - Country:US
Mailing Address - Phone:513-585-7800
Mailing Address - Fax:513-585-7950
Practice Address - Street 1:3200 BURNET AVE
Practice Address - Street 2:5 RIDGEWAY
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3019
Practice Address - Country:US
Practice Address - Phone:513-585-7800
Practice Address - Fax:513-585-7950
Is Sole Proprietor?:No
Enumeration Date:2009-04-30
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5390133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0462231Medicaid
OH2565399Medicaid