Healthcare Provider Details

I. General information

NPI: 1285664789
Provider Name (Legal Business Name): GREGORY C ZENNI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 12/17/2019
Certification Date: 12/17/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4750 E GALBRAITH RD STE 215
CINCINNATI OH
45236-6706
US

IV. Provider business mailing address

4750 E GALBRAITH RD STE 215
CINCINNATI OH
45236-6706
US

V. Phone/Fax

Practice location:
  • Phone: 513-421-3494
  • Fax: 513-345-4886
Mailing address:
  • Phone: 513-421-3494
  • Fax: 513-345-4886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number29635
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number35065279Z
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35065279Z
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number29635
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: