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General NPI Number Information
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NPI Number | 1811419716
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Entity Type | Individual
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Provider Name | SHIPRA JAIN M.D
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Gender | Female
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Dates
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Enumeration Date | 07/12/2017
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Last Update Date | 07/10/2023
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Provider Practice Location Address
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Address Line | 3333 BURNET AVE ML 7009
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City | CINCINNATI
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State | OH
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Zip | 45229-3026
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Country | US
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Telephone | 513-636-4200
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Fax |
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Provider Business Mailing Address
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Address Line | SUNY DOWNSTATE MEDICAL CENTER 450 CLARKSON AVE, BOX 49
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City | BROOKLYN
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State | NY
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Zip | 11203-0049
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Country | US
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Telephone |
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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 | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 35.139707
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License Number State | OH
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