Provider Demographics
NPI:1417417445
Name:EFFENDI, MALEEH TARIQ (MD)
Entity Type:Individual
Prefix:
First Name:MALEEH
Middle Name:TARIQ
Last Name:EFFENDI
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 1:231 ALBERT B. SABIN WAY
Mailing Address - Street 2:P.O. BOX 670513
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45267-0513
Mailing Address - Country:US
Mailing Address - Phone:513-558-4363
Mailing Address - Fax:513-558-0570
Practice Address - Street 1:234 GOODMAN STEET
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-0796
Practice Address - Country:US
Practice Address - Phone:513-558-4363
Practice Address - Fax:513-558-0570
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program