Provider Demographics
NPI:1629305909
Name:KRASIK, ELLEN FRANCES (MD/PHD)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:FRANCES
Last Name:KRASIK
Suffix:
Gender:F
Credentials:MD/PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 631104
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-1104
Mailing Address - Country:US
Mailing Address - Phone:513-585-2000
Mailing Address - Fax:419-866-5453
Practice Address - Street 1:2139 AUBURN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2906
Practice Address - Country:US
Practice Address - Phone:513-585-2000
Practice Address - Fax:419-866-5453
Is Sole Proprietor?:No
Enumeration Date:2009-11-07
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY46412207ZP0102X
IN01073037A207ZP0102X
CAA107995207ZP0102X
OH35122239207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology