Provider Demographics
NPI:1598329757
Name:TIKHTMAN, RAISA OLIVIA
Entity Type:Individual
Prefix:
First Name:RAISA
Middle Name:OLIVIA
Last Name:TIKHTMAN
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 1:231 ALBERT SABIN WAY
Mailing Address - Street 2:MSB 6504
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45267-0528
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:231 ALBERT SABIN WAY
Practice Address - Street 2:MSB 6504
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45267-0528
Practice Address - Country:US
Practice Address - Phone:513-558-4198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-23
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program