Healthcare Provider Details

I. General information

NPI: 1053374678
Provider Name (Legal Business Name): LEILA JANE SAXENA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 01/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 CRESCENT AVE
CINCINNATI OH
45215-4406
US

IV. Provider business mailing address

636256 CENTRAL CREDENTIALING
CINCINNATI OH
45263-6256
US

V. Phone/Fax

Practice location:
  • Phone: 513-821-0275
  • Fax: 513-821-3621
Mailing address:
  • Phone: 513-585-5501
  • Fax: 513-585-5511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35-091713
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: