Healthcare Provider Details

I. General information

NPI: 1568099372
Provider Name (Legal Business Name): CHAWISA JANJINDAMAI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

423 HOGE ST APT 202
CINCINNATI OH
45226-1347
US

V. Phone/Fax

Practice location:
  • Phone: 513-703-8766
  • Fax:
Mailing address:
  • Phone: 216-785-1882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number35.147326
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: