Healthcare Provider Details
I. General information
NPI: 1780926014
Provider Name (Legal Business Name): DANIELLE ELIZABETH CONNOR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/25/2013
Last Update Date: 08/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8240 NORTHCREEK DR
CINCINNATI OH
45236-2283
US
IV. Provider business mailing address
4685 FOREST AVE
CINCINNATI OH
45212-3397
US
V. Phone/Fax
- Phone: 513-246-7000
- Fax: 513-246-5284
- Phone: 513-246-7000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 35.128373 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: