Healthcare Provider Details

I. General information

NPI: 1639977218
Provider Name (Legal Business Name): ROBERT NEIL GENGLER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2025
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4015 EXECUTIVE PARK DR STE 320
CINCINNATI OH
45241-4015
US

IV. Provider business mailing address

PO BOX 8073
CINCINNATI OH
45208-0073
US

V. Phone/Fax

Practice location:
  • Phone: 513-563-0488
  • Fax:
Mailing address:
  • Phone: 937-821-6610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0039377
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.501667
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: