Healthcare Provider Details
I. General information
NPI: 1134157241
Provider Name (Legal Business Name): JOSEPH W LURIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/29/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3333 BURNET AVE
CINCINNATI OH
45229-3026
US
IV. Provider business mailing address
3333 BURNET AVE ML 6015
CINCINNATI OH
45229-3039
US
V. Phone/Fax
- Phone: 513-636-0800
- Fax: 513-803-0823
- Phone: 513-636-0800
- Fax: 513-803-0823
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0204X |
| Taxonomy | Pediatric Emergency Medicine (Pediatrics) Physician |
| License Number | 35-06-0718 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: