Basic Information
Provider Information
NPI: 1528498052
EntityType: 2
ReplacementNPI:  
OrganizationName: TRIHEALTH OS, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: HAND SURGERY SPECIALIST
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 637783
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452637783
CountryCode: US
TelephoneNumber: 5138534731
FaxNumber: 5135695199
Practice Location
Address1: 222 PIEDMONT AVE
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452194231
CountryCode: US
TelephoneNumber: 5139614263
FaxNumber: 5139611503
Other Information
ProviderEnumerationDate: 11/19/2013
LastUpdateDate: 11/19/2013
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
207XS0106X35.042929OHY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery

No ID Information.


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