1861445868 NPI number — TERESA ZEISER NP

Table of content: DR. CAMERON CALLAGHAN MD (NPI 1861933046)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861445868 NPI number — TERESA ZEISER NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZEISER
Provider First Name:
TERESA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NP
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:
1861445868
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/14/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7655 5 MILE RD
Provider Second Line Business Mailing Address:
SUITE 117
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45230-4326
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-947-7000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7655 5 MILE RD STE 117
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:
45230-4326
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-947-7000
Provider Business Practice Location Address Fax Number:
513-624-7525
Provider Enumeration Date:
05/18/2006

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: 363L00000X , with the licence number:  1097763 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: NP07640 , 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: 7100177280 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 352199392050 . This is a "CARE SOURCE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000730300 . This is a "ANTHEM BLUE SHIELD" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2647989 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 201032540 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: IDX83524 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 352199392 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".




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