1851308597 NPI number — DR. CYMA KHALILY MD

Table of content: DR. CYMA KHALILY MD (NPI 1851308597)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851308597 NPI number — DR. CYMA KHALILY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KHALILY
Provider First Name:
CYMA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1851308597
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/14/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8624-A WINTON RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45231-4817
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-522-2120
Provider Business Mailing Address Fax Number:
513-522-9890

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8624-A WINTON RD
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:
45231-4817
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-522-2120
Provider Business Practice Location Address Fax Number:
513-522-9890
Provider Enumeration Date:
08/02/2006

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: 2084P0800X , with the licence number:  60037 , 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: 0004208025 . This is a "AETNA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 0986652 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 311303853 . This is a "HUMANA OF KY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 311303853 . This is a "CONNECTICUT GENERAL LIFE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 260010719 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000009998 . This is a "BCBS OF TEXAS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 042485000 . This is a "MAGELLAN HEALTH SERVICES" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 31130385300 . This is a "OHIO BWC" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1520646 . This is a "UNITED BEHAVIORAL HEALTH" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 311303853 . This is a "CHAMPUS TRICARE" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 311303853001 . This is a "CCN NETWORK" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 311303853 . This is a "HEALTHSPAN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0004208025 . This is a "AETNA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 000000015850 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 311303853 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 72503 . This is a "CIGNA BEHAVIORAL HEALTH" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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