Provider Demographics
NPI:1356631816
Name:OHIO KIDNEY AND HYPERTENSION SPECIALISTS LLC
Entity type:Organization
Organization Name:OHIO KIDNEY AND HYPERTENSION SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RATNAJA
Authorized Official - Middle Name:
Authorized Official - Last Name:KATNENI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-244-8505
Mailing Address - Street 1:4347 PORTAGE ST NW
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-7371
Mailing Address - Country:US
Mailing Address - Phone:330-244-8505
Mailing Address - Fax:330-244-8521
Practice Address - Street 1:20455 LORAIN RD STE 104
Practice Address - Street 2:
Practice Address - City:FAIRVIEW PARK
Practice Address - State:OH
Practice Address - Zip Code:44126-3529
Practice Address - Country:US
Practice Address - Phone:440-331-4294
Practice Address - Fax:440-356-0660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-18
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2007969207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty