1134562614 NPI number — BENJAMIN S MANTELL MD, PHD

Table of content: BENJAMIN S MANTELL MD, PHD (NPI 1134562614)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134562614 NPI number — BENJAMIN S MANTELL MD, PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MANTELL
Provider First Name:
BENJAMIN
Provider Middle Name:
S
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD, PHD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134562614
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/28/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3333 BURNET AVE, CINCINNATI CHILDREN'S HOSPITAL MED CTR
Provider Second Line Business Mailing Address:
THE HEART INSTITUTE, MLC 2003
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45229-3026
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-803-1675
Provider Business Mailing Address Fax Number:
513-636-3952

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3333 BURNET AVE
Provider Second Line Business Practice Location Address:
THE HEART INSTITUTE, CINCINNATI CHILDREN'S HOSPITAL MED
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45229-3026
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-803-1675
Provider Business Practice Location Address Fax Number:
513-636-3952
Provider Enumeration Date:
04/15/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  35.147922 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2080P0202X , with the licence number: 35.147922 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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