Provider Demographics
NPI:1285520858
Name:BASKOTA, GANGA
Entity type:Individual
Prefix:
First Name:GANGA
Middle Name:
Last Name:BASKOTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 REYNOLDSBURG NEW ALBANY RD
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004-9613
Mailing Address - Country:US
Mailing Address - Phone:614-558-7319
Mailing Address - Fax:
Practice Address - Street 1:702 REYNOLDSBURG NEW ALBANY RD
Practice Address - Street 2:
Practice Address - City:BLACKLICK
Practice Address - State:OH
Practice Address - Zip Code:43004-9613
Practice Address - Country:US
Practice Address - Phone:614-558-7319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH522056163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant