Provider Demographics
NPI:1952312787
Name:BAKSHI, KINNARI KALIND (MD)
Entity type:Individual
Prefix:MRS
First Name:KINNARI
Middle Name:KALIND
Last Name:BAKSHI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:7601 CASTAR AVENUE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152
Mailing Address - Country:US
Mailing Address - Phone:215-342-0440
Mailing Address - Fax:215-745-3950
Practice Address - Street 1:7601 CASTAR AVENUE
Practice Address - Street 2:SUITE 204
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152
Practice Address - Country:US
Practice Address - Phone:215-342-0440
Practice Address - Fax:215-745-3950
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
PAMD026149E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2638693000OtherKEYSTONE HEALTH PLAN EAST
PA57298OtherAETNA
PA2638693000OtherKEYSTONE HEALTH PLAN EAST
B29969Medicare UPIN