Provider Demographics
NPI:1992422067
Name:CURTIS, CHAZARAY LONTE'E
Entity type:Individual
Prefix:
First Name:CHAZARAY
Middle Name:LONTE'E
Last Name:CURTIS
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 1:1639 CENTERRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-5228
Mailing Address - Country:US
Mailing Address - Phone:513-551-6312
Mailing Address - Fax:
Practice Address - Street 1:1639 CENTERRIDGE AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-5228
Practice Address - Country:US
Practice Address - Phone:513-551-6312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-20
Last Update Date:2024-06-06
Deactivation Date:2023-08-26
Deactivation Code:
Reactivation Date:2024-06-04
Provider Licenses
StateLicense IDTaxonomies
OHRY672806172A00000X
374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No172A00000XOther Service ProvidersDriver