Healthcare Provider Details

I. General information

NPI: 1801478052
Provider Name (Legal Business Name): PAUL IMBRIANO JR. DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2021
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3024 BURNET AVE
CINCINNATI OH
45219-2420
US

IV. Provider business mailing address

20 CINDY LN
ROWLEY MA
01969-2346
US

V. Phone/Fax

Practice location:
  • Phone: 513-221-2828
  • Fax: 513-872-5721
Mailing address:
  • Phone: 781-820-3375
  • Fax: 888-972-9271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number321369-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: