Provider Demographics
NPI:1407802465
Name:FIRESTEIN, SCOTT
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:FIRESTEIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 E GALBRAITH RD STE 202
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-2754
Mailing Address - Country:US
Mailing Address - Phone:513-418-5700
Mailing Address - Fax:513-924-8559
Practice Address - Street 1:4700 E GALBRAITH RD STE 202
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2754
Practice Address - Country:US
Practice Address - Phone:513-418-5700
Practice Address - Fax:513-924-8559
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35069037207V00000X
OH35.069037207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2106910Medicaid
OHFI0864596Medicare PIN
OH2106910Medicaid