Provider Demographics
NPI:1447440953
Name:PHYSICIAN ASSOCIATES OF NORTHERN CINCINNATI
Entity type:Organization
Organization Name:PHYSICIAN ASSOCIATES OF NORTHERN CINCINNATI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:INMA
Authorized Official - Middle Name:C
Authorized Official - Last Name:PRIETO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-769-1777
Mailing Address - Street 1:3801 HAUCK RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-4607
Mailing Address - Country:US
Mailing Address - Phone:513-769-1777
Mailing Address - Fax:513-769-3999
Practice Address - Street 1:3801 HAUCK RD
Practice Address - Street 2:SUITE A
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-4607
Practice Address - Country:US
Practice Address - Phone:513-769-1777
Practice Address - Fax:513-769-3999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty