1750687950 NPI number — JUDITH ANN DIMUZIO CNS

Table of content: JUDITH ANN DIMUZIO CNS (NPI 1750687950)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750687950 NPI number — JUDITH ANN DIMUZIO CNS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DIMUZIO
Provider First Name:
JUDITH
Provider Middle Name:
ANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CNS
Provider Gender Code:
F

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:
1750687950
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3200 BURNET AVE
Provider Second Line Business Mailing Address:
3 SOUTH
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45229-3019
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-475-7400
Provider Business Mailing Address Fax Number:
513-475-8201

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
222 PIEDMONT AVE
Provider Second Line Business Practice Location Address:
SUITE4300
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45219-4231
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-475-7400
Provider Business Practice Location Address Fax Number:
513-475-8201
Provider Enumeration Date:
02/04/2011

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: 364S00000X , with the licence number:  06019-NS , 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)

  • Identifier: 201013450 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3127048 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com