Basic Information
Provider Information
NPI: 1164686929
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PARIKH
FirstName: JAGROOP
MiddleName: MAVI
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: MAVI
OtherFirstName: JAGROOP
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: M.D.
OtherLastNameType: 1
Mailing Information
Address1: 3333 BURNET AVE
Address2: MLC 2001
City: CINCINNATI
State: OH
PostalCode: 452293026
CountryCode: US
TelephoneNumber: 5136364408
FaxNumber: 5136367337
Practice Location
Address1: 3333 BURNET AVE
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452293026
CountryCode: US
TelephoneNumber: 5136364408
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/10/2008
LastUpdateDate: 09/26/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207LP3000X35.121534OHY Allopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology

No ID Information.


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