Provider Demographics
NPI:1396838215
Name:SIFRI EYE CENTER, LTD, LLC
Entity Type:Organization
Organization Name:SIFRI EYE CENTER, LTD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SIFRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-922-1550
Mailing Address - Street 1:2745 ANDERSON FERRY RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-2100
Mailing Address - Country:US
Mailing Address - Phone:513-922-1550
Mailing Address - Fax:513-922-1572
Practice Address - Street 1:2745 ANDERSON FERRY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-2100
Practice Address - Country:US
Practice Address - Phone:513-922-1550
Practice Address - Fax:513-922-1572
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SIFRI EYE CENTER, LTD, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-02
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-07-0204-S174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0249145Medicaid
OH9284521Medicare ID - Type Unspecified
OH0249145Medicaid