Healthcare Provider Details

I. General information

NPI: 1134275530
Provider Name (Legal Business Name): CITY OF CINCINNATI - BOARD OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 05/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 E MCMICKEN AVE
CINCINNATI OH
45202-6549
US

IV. Provider business mailing address

3101 BURNET AVE
CINCINNATI OH
45229-3014
US

V. Phone/Fax

Practice location:
  • Phone: 513-352-6362
  • Fax: 513-352-6360
Mailing address:
  • Phone: 513-357-7289
  • Fax: 513-357-7396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. NOBLE MASERU
Title or Position: HEALTH COMMISSIONER
Credential: PH.D,MPH
Phone: 513-357-7280