MEDICARE: SIFRI EYE CENTER, LTD, LLC

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	174400000X	Specialist	35-07-0204-S	OH

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

General Provider Information

NPI Number	:	1396838215
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIFRI EYE CENTER, LTD, LLC

Provider Business Mailing Address
First Line	:	2745 ANDERSON FERRY RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-2100
Country	:	US
Telephone Number	:	513-922-1550
Fax Number	:	513-922-1572

Provider Business Practice Location Address
First Line	:	2745 ANDERSON FERRY RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-2100
Country	:	US
Telephone Number	:	513-922-1550
Fax Number	:	513-922-1572

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MICHAEL DAVID SIFRI
Credential	:	M.D.
Telephone Number	:	513-922-1550

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	01/11/2012

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