Healthcare Provider Details

I. General information

NPI: 1366491821
Provider Name (Legal Business Name): AMAL H. ASSA'AD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 11/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE ML 2000
CINCINNATI OH
45229-3039
US

IV. Provider business mailing address

3333 BURNET AVE ML 2000
CINCINNATI OH
45229-3039
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-6771
  • Fax: 513-636-4615
Mailing address:
  • Phone: 513-636-4225
  • Fax: 513-636-2511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number35.062943
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License Number35.062943
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: