Provider Demographics
NPI:1285664789
Name:ZENNI, GREGORY C (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:C
Last Name:ZENNI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4750 E GALBRAITH RD STE 215
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-6706
Mailing Address - Country:US
Mailing Address - Phone:513-421-3494
Mailing Address - Fax:513-345-4886
Practice Address - Street 1:4750 E GALBRAITH RD STE 215
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-6706
Practice Address - Country:US
Practice Address - Phone:513-421-3494
Practice Address - Fax:513-345-4886
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY296352086S0129X, 208600000X
OH35065279Z2086S0129X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0928830Medicaid
65279OtherCHOICE CARE/HUMANA
1702170OtherUNITEDHEALTHCARE
000000211144OtherANTHEM
KY8330OtherKY BCBS
310804060034OtherCARESOURCE
IN200001400Medicaid
KY64933153Medicaid
1702170OtherUNITEDHEALTHCARE
IN200001400Medicaid
F58635Medicare UPIN
65279OtherCHOICE CARE/HUMANA
310804060034OtherCARESOURCE
OH0746639Medicare ID - Type UnspecifiedOH MEDICARE
OH0746639Medicare PIN