Provider Demographics
NPI:1841490372
Name:KALEKA, RAVNEET KAUR
Entity type:Individual
Prefix:DR
First Name:RAVNEET
Middle Name:KAUR
Last Name:KALEKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1136 WESTOWNE DR
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-2175
Mailing Address - Country:US
Mailing Address - Phone:920-720-8200
Mailing Address - Fax:
Practice Address - Street 1:1136 WESTOWNE DR
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-2175
Practice Address - Country:US
Practice Address - Phone:920-720-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-094672207R00000X
390200000X
WI65362207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3005376Medicaid
WI1841490372Medicaid
OHKA4282371Medicare PIN
OH3005376Medicaid
WI1841490372Medicare PIN