Provider Demographics
NPI:1427258458
Name:BRAFMAN, SHANA B (OD)
Entity type:Individual
Prefix:DR
First Name:SHANA
Middle Name:B
Last Name:BRAFMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8970 WINTON ROAD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-4644
Mailing Address - Country:US
Mailing Address - Phone:513-522-0035
Mailing Address - Fax:513-522-3416
Practice Address - Street 1:8970 WINTON RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-3818
Practice Address - Country:US
Practice Address - Phone:513-522-0035
Practice Address - Fax:513-522-3416
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046009953152W00000X
OH6242-T3157152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL046009953Medicaid