Provider Demographics
NPI:1124025499
Name:LEEROBINSON, AYSE (MD)
Entity Type:Individual
Prefix:
First Name:AYSE
Middle Name:
Last Name:LEEROBINSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 42471
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-0471
Mailing Address - Country:US
Mailing Address - Phone:513-965-8091
Mailing Address - Fax:513-965-9081
Practice Address - Street 1:10547 MONTGOMERY RD
Practice Address - Street 2:STE 700
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-4459
Practice Address - Country:US
Practice Address - Phone:513-965-8041
Practice Address - Fax:513-965-8091
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35049682208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0582669Medicaid
KY64785017Medicaid
KY64785017Medicaid
OH250013954Medicare PIN
OH0565127Medicare PIN