MEDICARE: CYNTHIA BISCHOFF

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	133V00000X	Registered Dietitian	0616	KY

General Provider Information

NPI Number	:	1770579815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA BISCHOFF

Provider Business Mailing Address
First Line	:	2300 CHAMBER CENTER DR
Second Line	:	SUITE 200
City	:	LAKESIDE PARK
State	:	KY
Zip	:	41017-1673
Country	:	US
Telephone Number	:	859-344-5555
Fax Number	:	859-655-8911

Provider Business Practice Location Address
First Line	:	1500 JAMES SIMPSON JR WAY
Second Line	:	SUITE 301
City	:	COVINGTON
State	:	KY
Zip	:	41011-0801
Country	:	US
Telephone Number	:	859-655-8910
Fax Number	:	859-655-8911

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

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	09/18/2015

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Directions to “ CYNTHIA BISCHOFF ” Practice Location

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