Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 35.097529 | OH |
N | 207QA0401X | Family Doctor - Addiction Medicine | 35.097529 | OH |
NPI | 1629267828 |
---|---|
Provider Name | Anna Gensic |
First Address | Cincinnati, OH 45229-3019 |
Second Address | Cincinnati, OH 45219 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2007 |
Last Update Date | 02/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0051448 | (05) | OH |
201040380 | (05) | IN |
7100175330 | (05) | KY |