Healthcare Provider Details

I. General information

NPI: 1891846564
Provider Name (Legal Business Name): AIMEE J RUSK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 12/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2753 OBSERVATORY AVE
CINCINNATI OH
45208-2231
US

IV. Provider business mailing address

2753 OBSERVATORY AVE
CINCINNATI OH
45208-2231
US

V. Phone/Fax

Practice location:
  • Phone: 513-282-4808
  • Fax: 513-275-6704
Mailing address:
  • Phone: 513-282-4808
  • Fax: 513-275-6804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35-056365
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: