Healthcare Provider Details

I. General information

NPI: 1467177519
Provider Name (Legal Business Name): FLAVIO AJDINAJ PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2022
Last Update Date: 10/27/2023
Certification Date: 10/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1222 S PATTERSON BLVD STE 110
DAYTON OH
45402-2643
US

IV. Provider business mailing address

1095 SUNNYSLOPE DR
CINCINNATI OH
45229-1123
US

V. Phone/Fax

Practice location:
  • Phone: 937-424-1440
  • Fax:
Mailing address:
  • Phone: 216-210-4815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03440339
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: