Provider Demographics
NPI:1437118346
Name:GENNARI, LISA C (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:C
Last Name:GENNARI
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 1:10700 MONTGOMERY RD
Mailing Address - Street 2:SUITE 311
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242
Mailing Address - Country:US
Mailing Address - Phone:513-794-1500
Mailing Address - Fax:513-794-0015
Practice Address - Street 1:10700 MONTGOMERY RD
Practice Address - Street 2:SUITE 311
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242
Practice Address - Country:US
Practice Address - Phone:513-794-1500
Practice Address - Fax:513-794-0015
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35065968G207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2252619Medicaid
OH2252619Medicaid
OHGE4038623Medicare ID - Type Unspecified