Provider Demographics
NPI:1962064303
Name:POKHREL, ESANA
Entity type:Individual
Prefix:
First Name:ESANA
Middle Name:
Last Name:POKHREL
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 1:6045 BRIDGETOWN RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45248-3049
Mailing Address - Country:US
Mailing Address - Phone:513-981-4105
Mailing Address - Fax:513-347-4620
Practice Address - Street 1:6045 BRIDGETOWN RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45248-3049
Practice Address - Country:US
Practice Address - Phone:513-981-4105
Practice Address - Fax:513-347-4620
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-06
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH35.145451207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program