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NPI Code Detail

MEDICARE: PHYSICIAN ASSOCIATES OF NORTHERN CINCINNATI

MEDICARE: PHYSICIAN ASSOCIATES OF NORTHERN CINCINNATI
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
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1447440953
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHYSICIAN ASSOCIATES OF NORTHERN CINCINNATI
Provider Business Mailing Address
First Line : 3801 HAUCK RD
Second Line : SUITE A
City : CINCINNATI
State : OH
Zip : 45241-4607
Country : US
Telephone Number : 513-769-1777
Fax Number : 513-769-3999
Provider Business Practice Location Address
First Line : 3801 HAUCK RD
Second Line : SUITE A
City : CINCINNATI
State : OH
Zip : 45241-4607
Country : US
Telephone Number : 513-769-1777
Fax Number : 513-769-3999
Authorized Official
Title or Position : PRESIDENT
Name : DR. INMA C PRIETO
Credential : MD
Telephone Number : 513-769-1777
Provider Enumeration Date : 07/31/2007
Last Update Date : 10/21/2024

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Directions to “PHYSICIAN ASSOCIATES OF NORTHERN CINCINNATI ” Practice Location

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