Provider Demographics
NPI:1609080837
Name:CAFARDI, JENNIFER (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:CAFARDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 WILLIAM HOWARD TAFT RD FL 2
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2610
Mailing Address - Country:US
Mailing Address - Phone:513-263-8551
Mailing Address - Fax:513-366-4480
Practice Address - Street 1:2123 AUBURN AVE STE 210
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219
Practice Address - Country:US
Practice Address - Phone:513-579-9191
Practice Address - Fax:513-579-0350
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.097057207N00000X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100345520Medicaid
OH935806OtherANTHEM BC/BS
OH0065685Medicaid
AL051598306OtherBCBS
AL051598308OtherBCBS
AL051598303OtherBCBS
AL051598305OtherBCBS
AL110510Medicaid
AL051598307OtherBCBS
AL110512Medicaid
AL051598304OtherBCBS
MS06924257Medicaid
AL110284Medicaid
AL110284Medicaid