Healthcare Provider Details

I. General information

NPI: 1548449630
Provider Name (Legal Business Name): SREEHARSHA MASINENI MD, MBBS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2007
Last Update Date: 06/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2139 AUBURN AVE # LEVELC
CINCINNATI OH
45219
US

IV. Provider business mailing address

2139 AUBURN AVE # LEVELC
CINCINNATI OH
45219-2906
US

V. Phone/Fax

Practice location:
  • Phone: 513-585-1120
  • Fax: 513-585-4897
Mailing address:
  • Phone: 513-585-1120
  • Fax: 513-585-4897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number35.122188
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number35.122188
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: