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General NPI Number Information
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NPI Number | 1629267828
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Entity Type | Individual
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Provider Name | ANNA GENSIC MD
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Gender | Female
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Dates
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Enumeration Date | 10/24/2007
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Last Update Date | 07/02/2018
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Provider Practice Location Address
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Address Line | 234 GOODMAN ST ML 0769
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City | CINCINNATI
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State | OH
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Zip | 45219
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Country | US
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Telephone | 513-558-5281
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Fax | 513-558-5791
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Provider Business Mailing Address
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Address Line | 3200 BURNET AVE 3 SOUTH, CREDENTIALING
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City | CINCINNATI
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State | OH
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Zip | 45229-3019
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Country | US
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Telephone | 513-558-5281
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Fax | 513-558-5791
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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 | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 35.097529
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 35.097529
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License Number State | OH
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