Healthcare Provider Details

I. General information

NPI: 1720924228
Provider Name (Legal Business Name): JONATHON ARYEH CHRIQUI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6809 MAIN ST UNIT 313
CINCINNATI OH
45244-3470
US

IV. Provider business mailing address

2195 BLUE GRASS LN
CINCINNATI OH
45237-3525
US

V. Phone/Fax

Practice location:
  • Phone: 513-399-7880
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: