Basic Information
Provider Information
NPI: 1174891949
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARMON
FirstName: YARON
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3333 BURNET AVENUE
Address2: ML 5012
City: CINCINNATI
State: OH
PostalCode: 452293026
CountryCode: US
TelephoneNumber: 5136364315
FaxNumber: 5136367905
Practice Location
Address1: 3333 BURNET AVENUE
Address2: ML 5012
City: CINCINNATI
State: OH
PostalCode: 452293026
CountryCode: US
TelephoneNumber: 5136364315
FaxNumber: 5136367905
Other Information
ProviderEnumerationDate: 12/08/2011
LastUpdateDate: 12/08/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  Y Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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