Healthcare Provider Details

I. General information

NPI: 1558740282
Provider Name (Legal Business Name): PAIN SPECIALISTS OF CINCINNATI, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2015
Last Update Date: 03/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3328 WESTBOURNE DR
CINCINNATI OH
45248-5133
US

IV. Provider business mailing address

3328 WESTBOURNE DR
CINCINNATI OH
45248-5133
US

V. Phone/Fax

Practice location:
  • Phone: 513-807-3564
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: ZEESHAN TAYEB
Title or Position: OWNER
Credential: MD
Phone: 513-807-3564