Healthcare Provider Details
I. General information
NPI: 1922034057
Provider Name (Legal Business Name): ALAN H ZALTA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/23/2006
Last Update Date: 02/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
222 PIEDMONT AVE SUITE 1700
CINCINNATI OH
45219-4231
US
IV. Provider business mailing address
1945 CEI DRIVE
CINCINNATI OH
45242-3311
US
V. Phone/Fax
- Phone: 513-475-7292
- Fax: 513-475-7369
- Phone: 513-984-5133
- Fax: 513-569-3941
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | 35-05-0234 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: