=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891858023
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INDEPENDENT PERINATAL ASSOCIATES OF CINCINNATI
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/19/2006
-----------------------------------------------------
Last Update Date | 01/28/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2123 AUBURN AVE SUITE 115
-----------------------------------------------------
City | CINCINNATI
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45219-2906
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-651-4722
-----------------------------------------------------
Fax | 513-651-5560
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 634499
-----------------------------------------------------
City | CINCINNATI
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45263-0041
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-474-9800
-----------------------------------------------------
Fax | 513-474-9805
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. TARIQ SIDDIQI
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 513-474-9800
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 35046083
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------