Healthcare Provider Details

I. General information

NPI: 1902148745
Provider Name (Legal Business Name): ALISHA GANDHI KUMAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2013
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3310 MERCY HEALTH BLVD # 200
CINCINNATI OH
45211
US

IV. Provider business mailing address

1945 CEI DR
BLUE ASH OH
45242-5664
US

V. Phone/Fax

Practice location:
  • Phone: 513-984-5133
  • Fax:
Mailing address:
  • Phone: 513-569-3741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number51837
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number130457
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: