Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 35-086334 | OH |
NPI | 1184691230 |
---|---|
Provider Name | Dr. Jennifer Bryna Katz Manders |
First Address | Cincinnati, OH 45219-2906 |
Second Address | Cincinnati, OH 45227-2172 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2006 |
Last Update Date | 29/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200521920 | (05) | IN |
2577019 | (05) | OH |
64101827 | (05) | KY |