Provider Demographics
NPI:1073951711
Name:PERRY, TANYA (DO)
Entity Type:Individual
Prefix:DR
First Name:TANYA
Middle Name:
Last Name:PERRY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:TANYA
Other - Middle Name:
Other - Last Name:MOKHATEB-RAFII
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3333 BURNET AVE. - ML 2003
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-4432
Mailing Address - Fax:513-636-3952
Practice Address - Street 1:3333 BURNET AVE. - ML 2003
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-4432
Practice Address - Fax:513-636-3952
Is Sole Proprietor?:No
Enumeration Date:2013-06-04
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.014977208000000X, 2080P0202X, 2080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology