Provider Demographics
NPI:1114922333
Name:KITCHENER, RABINDRA (MD)
Entity type:Individual
Prefix:
First Name:RABINDRA
Middle Name:
Last Name:KITCHENER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3006 N DIXIE HWY
Mailing Address - Street 2:STE 106
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-1335
Mailing Address - Country:US
Mailing Address - Phone:937-339-8513
Mailing Address - Fax:937-339-8603
Practice Address - Street 1:3006 N DIXIE HWY
Practice Address - Street 2:STE 106
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-1335
Practice Address - Country:US
Practice Address - Phone:937-339-8513
Practice Address - Fax:937-339-8603
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-3371-K2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0426631Medicaid
OH0478901Medicare PIN
A79492Medicare UPIN
OH0426631Medicaid
OH130022377Medicare PIN