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General NPI Number Information
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NPI Number | 1558453712
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Entity Type | Individual
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Provider Name | DOMINICK J DEBLASIO MD
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Gender | Male
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 07/19/2011
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Provider Practice Location Address
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Address Line | 3333 BURNET AVE., ML 5026 CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER
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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 | 513-636-7722
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Fax | 513-636-3737
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Provider Business Mailing Address
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Address Line | 3333 BURNET AVE., ML 5026 CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER
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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 | 513-636-7722
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Fax | 513-636-3737
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 35-083777
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License Number State | OH
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