Healthcare Provider Details

I. General information

NPI: 1376879205
Provider Name (Legal Business Name): SUSAN KUSCHNIR MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2009
Last Update Date: 10/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2123 AUBURN AVE SUITE 415
CINCINNATI OH
45219-2906
US

IV. Provider business mailing address

2123 AUBURN AVE SUITE 415
CINCINNATI OH
45219-2906
US

V. Phone/Fax

Practice location:
  • Phone: 513-281-8840
  • Fax: 513-281-5314
Mailing address:
  • Phone: 513-281-8840
  • Fax: 513-281-5314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number35088732
License Number StateOH

VIII. Authorized Official

Name: DR. SUSAN KUSCHNIR
Title or Position: OWNER
Credential: MD
Phone: 513-281-8840