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General NPI Number Information
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NPI Number | 1316199953
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Entity Type | Individual
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Provider Name | ELIZABETH C CORREA O.D
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Gender | Female
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Dates
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Enumeration Date | 10/14/2008
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Last Update Date | 01/24/2019
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Provider Practice Location Address
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Address Line | 2751 BLUE ROCK RD
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City | CINCINNATI
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State | OH
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Zip | 45239-6332
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Country | US
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Telephone | 513-741-4000
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Fax | 513-741-4056
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Provider Business Mailing Address
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Address Line | 10782 RUSHDEN CT
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City | POWELL
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State | OH
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Zip | 43065-7424
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Country | US
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Telephone | 614-325-0512
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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 | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | T2530
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5616
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License Number State | OH
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