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General NPI Number Information
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NPI Number | 1063581999
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Entity Type | Individual
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Provider Name | DEBORAH A FARIS PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 01/05/2016
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Provider Practice Location Address
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Address Line | 6139 GLENWAY AVE MEDICAL DEPARTMENT
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City | CINCINNATI
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State | OH
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Zip | 45211-6312
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Country | US
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Telephone | 513-346-3399
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Fax |
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Provider Business Mailing Address
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Address Line | 3688 CRESTNOLL LN
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City | CINCINNATI
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State | OH
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Zip | 45211-1816
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Country | US
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Telephone | 513-661-0010
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 50.000537
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License Number State | OH
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