Healthcare Provider Details

I. General information

NPI: 1316041635
Provider Name (Legal Business Name): SUMAN JANA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2006
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 PIEDMONT AVE
CINCINNATI OH
45219-4231
US

IV. Provider business mailing address

7642 READING RD
CINCINNATI OH
45237-3204
US

V. Phone/Fax

Practice location:
  • Phone: 513-475-7400
  • Fax: 513-475-8201
Mailing address:
  • Phone: 513-619-7766
  • Fax: 513-810-4400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberTP951
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License NumberTP951
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License NumberTP951
License Number StateKY
# 4
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number35.095531
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: