Provider Demographics
NPI:1194884957
Name:CIAMBARELLA, MATTHEW ERNEST (DC)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:ERNEST
Last Name:CIAMBARELLA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2859 BOUDINOT AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-1606
Mailing Address - Country:US
Mailing Address - Phone:513-981-6784
Mailing Address - Fax:513-389-4075
Practice Address - Street 1:2859 BOUDINOT AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-1606
Practice Address - Country:US
Practice Address - Phone:513-981-6784
Practice Address - Fax:513-389-4075
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3863111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2894006Medicaid
OH2894006Medicaid
OH4231503Medicare PIN