Healthcare Provider Details

I. General information

NPI: 1205280906
Provider Name (Legal Business Name): RTR NEPHROLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2016
Last Update Date: 06/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 AFFINITY PLACE
CINCINNATI OH
45231-3535
US

IV. Provider business mailing address

PO BOX 748010
CINCINNATI OH
45274-8010
US

V. Phone/Fax

Practice location:
  • Phone: 513-242-0695
  • Fax:
Mailing address:
  • Phone: 513-745-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number34777
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number01052489A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number35074794
License Number StateOH

VIII. Authorized Official

Name: DR. ALVARO A RYES
Title or Position: PRESIDENT
Credential: MD
Phone: 513-242-0695