Provider Demographics
NPI:1558316513
Name:SANITATO, JAMES JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JOSEPH
Last Name:SANITATO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2865 CHANCELLOR DR
Mailing Address - Street 2:SUITE 215
Mailing Address - City:CRESTVIEW HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-3912
Mailing Address - Country:US
Mailing Address - Phone:859-581-7120
Mailing Address - Fax:859-581-7207
Practice Address - Street 1:7730 MONTGOMERY RD
Practice Address - Street 2:SUITE 120
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-4283
Practice Address - Country:US
Practice Address - Phone:513-791-5999
Practice Address - Fax:513-791-1473
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2014-03-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35-043741207W00000X
KY28767207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100029870Medicaid
OH0537806Medicaid
KY64785975Medicaid
OH0537806Medicaid
KY0346311Medicare PIN
OHA80778Medicare UPIN
OH4263092Medicare PIN
OH0868029Medicare PIN