Healthcare Provider Details

I. General information

NPI: 1609623735
Provider Name (Legal Business Name): REGENLIFE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2024
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3328 WESTBOURNE DR
CINCINNATI OH
45248-5133
US

IV. Provider business mailing address

3328 WESTBOURNE DR
CINCINNATI OH
45248-5133
US

V. Phone/Fax

Practice location:
  • Phone: 513-922-2204
  • Fax: 859-331-4163
Mailing address:
  • Phone: 513-922-2204
  • Fax: 859-331-4163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ZEESHAN TAYEB
Title or Position: CHIEF MEDICAL OFFICER
Credential: MD
Phone: 513-922-2204