Healthcare Provider Details
I. General information
NPI: 1730332503
Provider Name (Legal Business Name): ILONA BRENER ALBRECHT D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/24/2008
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4335 W. DUBLIN-GRANVILLE RD.
DUBLIN OH
43017
US
IV. Provider business mailing address
4335 W. DUBLIN-GRANVILLE RD.
DUBLIN OH
43017
US
V. Phone/Fax
- Phone: 614-889-7772
- Fax: 614-764-0843
- Phone: 614-889-7772
- Fax: 614-764-0843
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 34.009775 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: