Provider Demographics
NPI:1467151159
Name:BISHOP-GABLE, TONYA SHENAE
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:SHENAE
Last Name:BISHOP-GABLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:895 CLINTON SPRINGS AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-1432
Mailing Address - Country:US
Mailing Address - Phone:513-714-8544
Mailing Address - Fax:
Practice Address - Street 1:2322 FERGUSON RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-3503
Practice Address - Country:US
Practice Address - Phone:513-922-3278
Practice Address - Fax:513-922-3473
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOP.017319-S156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician