1235933490 NPI number — AMY POUPORE MD, PHD

Table of content: AMY POUPORE MD, PHD (NPI 1235933490)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235933490 NPI number — AMY POUPORE MD, PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
POUPORE
Provider First Name:
AMY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD, PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROSSI
Provider Other First Name:
AMY
Provider Other Middle Name:
POUPORE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD, PHD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1235933490
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/02/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3130 HIGHLAND AVE
Provider Second Line Business Mailing Address:
GROUND FLOOR, ATTN: UC HEALTH DERMATOLOGY
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45219-2399
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-584-4644
Provider Business Mailing Address Fax Number:
513-584-1559

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3130 HIGHLAND AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45219-2399
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-584-4644
Provider Business Practice Location Address Fax Number:
513-584-1559
Provider Enumeration Date:
04/04/2025

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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