Healthcare Provider Details

I. General information

NPI: 1124602255
Provider Name (Legal Business Name): MR. JAINISH SURESH SONI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2021
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 MERCY HEALTH BLVD
CINCINNATI OH
45211-1103
US

IV. Provider business mailing address

EAST MARKET STREET, 7TH FLOOR 1350
WARREN OH
44483
US

V. Phone/Fax

Practice location:
  • Phone: 330-841-9647
  • Fax: 330-841-9645
Mailing address:
  • Phone: 330-841-9647
  • Fax: 330-841-9645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.150070
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: