Healthcare Provider Details

I. General information

NPI: 1851955918
Provider Name (Legal Business Name): SAJID ALI LEELANI MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2019
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date: 03/28/2020
Reactivation Date: 04/15/2020

III. Provider practice location address

3200 VINE ST
CINCINNATI OH
45220-2213
US

IV. Provider business mailing address

3200 VINE ST
CINCINNATI OH
45220-2213
US

V. Phone/Fax

Practice location:
  • Phone: 513-861-3100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License Number35.152896
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: