Provider Demographics
NPI:1093030744
Name:TRI COUNTY ENT
Entity Type:Organization
Organization Name:TRI COUNTY ENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-825-5454
Mailing Address - Street 1:752 WAYCROSS RD.
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240
Mailing Address - Country:US
Mailing Address - Phone:513-825-5454
Mailing Address - Fax:513-825-5452
Practice Address - Street 1:752 WAYCROSS RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240
Practice Address - Country:US
Practice Address - Phone:513-825-5454
Practice Address - Fax:513-825-5452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA01704231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty