Kothari, Renu O

Kothari, Renu O is an individual health care provider with primary practice located at 591 Poquonnock Rd , Groton CT 06340-4571. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is her primary health care specialty. Kothari, Renu O can be contacted via phone (860) 449-8217.

Contact Information

Primary practice address
591 Poquonnock Rd Groton CT 06340-4571
Phone: (860) 449-8217
Fax: (860) 449-8323
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 5601 Rhode Island
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 20325 Connecticut
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X MD05601 Rhode Island
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 20325 Connecticut

Profile Details

NPI number 1871563700
LBN Legal business name Kothari, Renu O
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2006
Last updated Jun 3rd, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871563700 NPPES
Connecticut MEDICAID 008035572
Connecticut MEDICAID 7001845

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