Provider Demographics
NPI:1699190421
Name:TRIHEALTH W, LLC
Entity Type:Organization
Organization Name:TRIHEALTH W, LLC
Other - Org Name:TRISTATE GYNECOLOGIC ONCOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR VP CORP COUNSEL
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:NIENABER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-569-6062
Mailing Address - Street 1:PO BOX 635063
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5063
Mailing Address - Country:US
Mailing Address - Phone:513-853-4731
Mailing Address - Fax:513-569-5199
Practice Address - Street 1:10550 MONTGOMERY RD
Practice Address - Street 2:SUITE 22
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-4498
Practice Address - Country:US
Practice Address - Phone:513-862-1888
Practice Address - Fax:513-862-3616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-04
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35084002207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Single Specialty