Healthcare Provider Details

I. General information

NPI: 1497763593
Provider Name (Legal Business Name): TRIHEALTH PHYSICIAN INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 04/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 DIXMYTH AVE RM 1035-1
CINCINNATI OH
45220-2475
US

IV. Provider business mailing address

PO BOX 632895
CINCINNATI OH
45263-2895
US

V. Phone/Fax

Practice location:
  • Phone: 513-862-2692
  • Fax: 513-862-1584
Mailing address:
  • Phone: 513-569-5027
  • Fax: 513-569-5199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DONNA S NIENABER
Title or Position: VICE PRESIDENT
Credential:
Phone: 513-862-1400