MEDICARE: DR. MEERA MURTHI DR, PH.D., PSYCHOLOG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	6740	OH
2	103T00000X	Psychologist	018781	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NOT APPLICABLE	OTHER		NOT APPLICABLE

General Provider Information

NPI Number	:	1912250689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEERA MURTHI DR, PH.D., PSYCHOLOG

Provider Business Mailing Address
First Line	:	2650 MADISON RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45208-1332
Country	:	US
Telephone Number	:	513-772-9300
Fax Number	:	513-772-9302

Provider Business Practice Location Address
First Line	:	2650 MADISON RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45208-1332
Country	:	US
Telephone Number	:	513-772-9300
Fax Number	:	513-772-9302

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2012
Last Update Date	:	05/18/2015

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