Basic Information
Provider Information
NPI: 1861996423
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: THITOFF
FirstName: EMILY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2830 VICTORY PKWY
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452061785
CountryCode: US
TelephoneNumber: 5132453104
FaxNumber: 5135855511
Practice Location
Address1: 222 PIEDMONT AVE
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452194231
CountryCode: US
TelephoneNumber: 5134758521
FaxNumber: 5134757480
Other Information
ProviderEnumerationDate: 03/20/2018
LastUpdateDate: 05/20/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200X021271OHN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
363L00000X021271OHY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


Home