Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35.084866 | OH |
N | 2080P0201X | Pediatric Allergist | 35.084866 | OH |
NPI | 1841220167 |
---|---|
Provider Name | Jacob Jan Hendrik Bleesing |
First Address | Cincinnati, OH 45229-3039 |
Second Address | Cincinnati, OH 45229-3039 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 10/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H42148 | (02) | OH |