Provider Demographics
NPI:1497987838
Name:RAZZANO, ANDREW JOSEPH JR (DO)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JOSEPH
Last Name:RAZZANO
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6480 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-7961
Mailing Address - Country:US
Mailing Address - Phone:513-354-3700
Mailing Address - Fax:513-354-7651
Practice Address - Street 1:2835 MIAMI VILLAGE DR
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-4587
Practice Address - Country:US
Practice Address - Phone:513-354-3700
Practice Address - Fax:513-354-7651
Is Sole Proprietor?:No
Enumeration Date:2009-08-19
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.011213207X00000X, 207XX0005X
OH34011213207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPENDINGMedicaid
OHPENDINGMedicaid