Healthcare Provider Details

I. General information

NPI: 1790772804
Provider Name (Legal Business Name): CEI PHYSICIANS PSC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 02/03/2023
Certification Date: 02/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1945 CEI DR
BLUE ASH OH
45242-5664
US

IV. Provider business mailing address

1945 CEI DRIVE
CINCINNATI OH
45242-3311
US

V. Phone/Fax

Practice location:
  • Phone: 513-569-3741
  • Fax: 513-569-3941
Mailing address:
  • Phone: 513-569-3741
  • Fax: 513-569-3941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number0813AS
License Number StateOH

VIII. Authorized Official

Name: MS. TERI J KNIGHT
Title or Position: CORPORATE CREDENTIALS MANAGER
Credential:
Phone: 513-569-3741