Healthcare Provider Details

I. General information

NPI: 1538382437
Provider Name (Legal Business Name): JESSICA N GUARNASCHELLI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 07/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10550 MONTGOMERY RD SUITE 22
CINCINNATI OH
45242-4498
US

IV. Provider business mailing address

4685 FOREST AVE
CINCINNATI OH
45212-3397
US

V. Phone/Fax

Practice location:
  • Phone: 513-984-6973
  • Fax: 513-984-6976
Mailing address:
  • Phone: 513-853-4721
  • Fax: 513-852-8525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number35-092191
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: