Basic Information
Provider Information
NPI: 1518388560
EntityType: 2
ReplacementNPI:  
OrganizationName: TRIHEALTH W, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: ASSOCIATES IN OB-GYN
OtherOrganizationType: 5
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 632875
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452632875
CountryCode: US
TelephoneNumber: 5138534731
FaxNumber: 5135695199
Practice Location
Address1: 8221 CORNELL RD
Address2: SUITE 420
City: CINCINNATI
State: OH
PostalCode: 452492275
CountryCode: US
TelephoneNumber: 5137459045
FaxNumber: 5137459041
Other Information
ProviderEnumerationDate: 12/18/2013
LastUpdateDate: 12/18/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: NIENABER
AuthorizedOfficialFirstName: DONNA
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: SENIOR VP COUNSEL
AuthorizedOfficialTelephone: 5135696062
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MRS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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