MEDICARE: DR. GREGORY C ZENNI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0129X	Vascular Surgery Physician	29635	KY
2	2086S0129X	Vascular Surgery Physician	35065279Z	OH
3	208600000X	Surgery Physician	35065279Z	OH
4	208600000X	Surgery Physician	29635	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	65279	OTHER		CHOICE CARE/HUMANA
3	1702170	OTHER		UNITEDHEALTHCARE
4	000000211144	OTHER		ANTHEM
5	8330	OTHER	KY	KY BCBS
6	310804060034	OTHER		CARESOURCE
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285664789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY C ZENNI M.D.

Provider Business Mailing Address
First Line	:	4750 E GALBRAITH RD STE 215
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45236-6706
Country	:	US
Telephone Number	:	513-421-3494
Fax Number	:	513-345-4886

Provider Business Practice Location Address
First Line	:	4750 E GALBRAITH RD STE 215
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45236-6706
Country	:	US
Telephone Number	:	513-421-3494
Fax Number	:	513-345-4886

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	12/17/2019

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Directions to “ DR. GREGORY C ZENNI M.D.” Practice Location

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