Healthcare Provider Details

I. General information

NPI: 1255574018
Provider Name (Legal Business Name): JOSEPH RAYMOND ZENISEK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2009
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10506A MONTGOMERY RD
MONTGOMERY OH
45242-4402
US

IV. Provider business mailing address

10506A MONTGOMERY RD
MONTGOMERY OH
45242-4402
US

V. Phone/Fax

Practice location:
  • Phone: 513-246-2400
  • Fax: 513-246-4047
Mailing address:
  • Phone: 513-246-2400
  • Fax: 513-246-4047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number04-39838
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number01074594A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number35.155659
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number04-39838
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: