Healthcare Provider Details

I. General information

NPI: 1720994627
Provider Name (Legal Business Name): RYLEE BETH KIRSCHENBAUM PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4665 E GALBRAITH RD # 101
CINCINNATI OH
45236-2783
US

IV. Provider business mailing address

11 E VERNON LN
FORT THOMAS KY
41075-1954
US

V. Phone/Fax

Practice location:
  • Phone: 513-984-3500
  • Fax:
Mailing address:
  • Phone: 859-630-3552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.010469RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: