Provider Demographics
NPI:1760572853
Name:GENEIDY, AYMAN A (MD)
Entity Type:Individual
Prefix:
First Name:AYMAN
Middle Name:A
Last Name:GENEIDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 WAR ADMIRAL STE 4
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-8690
Mailing Address - Country:US
Mailing Address - Phone:859-236-6300
Mailing Address - Fax:859-236-6308
Practice Address - Street 1:150 WAR ADMIRAL STE 4
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-8690
Practice Address - Country:US
Practice Address - Phone:859-236-6300
Practice Address - Fax:859-236-6308
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY43832207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDI38889Medicare UPIN
KYP400028741Medicare PIN