Healthcare Provider Details

I. General information

NPI: 1366883191
Provider Name (Legal Business Name): AHARON GEFEN M.D., M.SC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2013
Last Update Date: 07/09/2013
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
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-1371
  • Fax: 513-803-1969
Mailing address:
  • Phone: 513-636-1371
  • Fax: 513-803-1969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number36681
License Number StateZZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: