Healthcare Provider Details

I. General information

NPI: 1689814071
Provider Name (Legal Business Name): DANIEL GARY LEINO M.D., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2009
Last Update Date: 01/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE ML 1035
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

3333 BURNET AVE ML 1035
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-8161
  • Fax: 513-636-3924
Mailing address:
  • Phone: 513-636-8161
  • Fax: 513-636-3924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0213X
TaxonomyPediatric Pathology Physician
License Number35.121840
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number35.121840
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: