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General NPI Number Information
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NPI Number | 1184400939
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Entity Type | Individual
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Provider Name | GALIYA RAISIN M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/07/2023
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Last Update Date | 03/05/2024
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Provider Practice Location Address
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Address Line | 3333 BURNET AVE DIVISION OF UROLOGY, MLC 5037
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City | CINCINNATI
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State | OH
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Zip | 45229
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Country | US
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Telephone | 513-803-3736
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Fax |
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Provider Business Mailing Address
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Address Line | 3333 BURNET AVE DIVISION OF UROLOGY, MLC 5037
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City | CINCINNATI
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State | OH
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Zip | 45229
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Country | US
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Telephone | 513-252-1455
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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 | 2088P0231X
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Taxonomy Name | Pediatric Urology Physician
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License Number | 57.254070
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License Number State | OH
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