Provider Demographics
NPI:1982367413
Name:KALIKOTAY, GANGA (PHARMD)
Entity Type:Individual
Prefix:
First Name:GANGA
Middle Name:
Last Name:KALIKOTAY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1748 W MARKET ST APT A
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-7010
Mailing Address - Country:US
Mailing Address - Phone:520-241-9243
Mailing Address - Fax:
Practice Address - Street 1:1948 BUCHHOLZER BLVD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44310-1849
Practice Address - Country:US
Practice Address - Phone:520-241-9243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03440522183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist