Healthcare Provider Details

I. General information

NPI: 1841245479
Provider Name (Legal Business Name): INTERNAL MEDICINE INFECTIOUS DISEASES ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 09/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10495 MONTGOMERY RD STE 17
CINCINNATI OH
45242-4468
US

IV. Provider business mailing address

PO BOX 632706
CINCINNATI OH
45263-2706
US

V. Phone/Fax

Practice location:
  • Phone: 513-984-2775
  • Fax: 513-984-5764
Mailing address:
  • Phone: 513-891-1008
  • Fax: 513-793-1032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SYLVANIA NG
Title or Position: PRESIDENT
Credential: MD
Phone: 513-984-2775