Healthcare Provider Details

I. General information

NPI: 1659674083
Provider Name (Legal Business Name): JOHN ALEXANDER MASINO MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2010
Last Update Date: 11/15/2022
Certification Date: 11/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2139 AUBURN AVE
CINCINNATI OH
45219-2906
US

IV. Provider business mailing address

2139 AUBURN AVE
CINCINNATI OH
45219-2906
US

V. Phone/Fax

Practice location:
  • Phone: 513-585-0855
  • Fax:
Mailing address:
  • Phone: 513-585-0855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number35.126990
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number57.018402
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: