Provider Demographics
NPI:1891858023
Name:INDEPENDENT PERINATAL ASSOCIATES OF CINCINNATI
Entity type:Organization
Organization Name:INDEPENDENT PERINATAL ASSOCIATES OF CINCINNATI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TARIQ
Authorized Official - Middle Name:
Authorized Official - Last Name:SIDDIQI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-474-9800
Mailing Address - Street 1:PO BOX 634499
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-0041
Mailing Address - Country:US
Mailing Address - Phone:513-474-9800
Mailing Address - Fax:513-474-9805
Practice Address - Street 1:2123 AUBURN AVE
Practice Address - Street 2:SUITE 115
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2906
Practice Address - Country:US
Practice Address - Phone:513-651-4722
Practice Address - Fax:513-651-5560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35046083174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0460782Medicaid
OH9319281Medicare PIN
OHC02168Medicare UPIN