| Kalpana Vishnupad, Llc | |
|
1458 Clear Brook Dr Dayton OH 45440-4317 | |
| (937) 848-9130 | |
| (937) 848-3329 |
| Full Name | Kalpana Vishnupad, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1458 Clear Brook Dr, Dayton, Ohio |
| Authorized Official Name and Position | Kalpana Vishnupad (CEO) |
| Authorized Official Contact | 9378489130 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kalpana Vishnupad, Llc 1458 Clear Brook Dr Dayton OH 45440-4317 Ph: () - | Kalpana Vishnupad, Llc 1458 Clear Brook Dr Dayton OH 45440-4317 Ph: (937) 848-9130 |
| NPI Number | 1225219272 |
|---|---|
| Provider Enumeration Date | 11/19/2007 |
| Last Update Date | 02/27/2013 |
| Medicare PECOS PAC ID | 0547270977 |
|---|---|
| Medicare Enrollment ID | O20060501000410 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225219272 | NPI | - | NPPES |
| 2052906 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP0016X | Psychologist - Prescribing (medical) | 35-07-3908-V (Ohio) | Primary |
| Provider Name | Kalpana K Vishnupad |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598755662 PECOS PAC ID: 5890696850 Enrollment ID: I20040114000405 |
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