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General NPI Number Information
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NPI Number | 1184955601
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Entity Type | Organization
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Legal Business Name | TRISTATE SLEEP AND PAIN MANAGEMENT
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Dates
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Enumeration Date | 01/22/2010
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Last Update Date | 01/22/2010
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Provider Practice Location Address
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Address Line | 1275 E KEMPER RD
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City | CINCINNATI
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State | OH
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Zip | 45246-3901
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Country | US
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Telephone | 513-671-3101
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Fax | 513-671-4159
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Provider Business Mailing Address
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Address Line | 71 CAVALIER BLVD SUITE 219
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City | FLORENCE
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State | KY
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Zip | 41042-5121
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Country | US
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Telephone | 859-746-2300
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Fax | 859-746-0207
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARTIN B SCHARF
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Credential |
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Telephone | 513-671-3101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 35-032638
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 34-004296
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License Number State | OH
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