Provider Demographics
NPI:1790197325
Name:KALEEM, TASNEEM (MD)
Entity Type:Individual
Prefix:
First Name:TASNEEM
Middle Name:
Last Name:KALEEM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4685 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-3397
Mailing Address - Country:US
Mailing Address - Phone:513-853-4721
Mailing Address - Fax:
Practice Address - Street 1:3035 HAMILTON MASON RD STE 204
Practice Address - Street 2:
Practice Address - City:FAIRFIELD TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45011-5545
Practice Address - Country:US
Practice Address - Phone:513-865-1223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-02
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1299482085R0001X
OH35.1373582085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022836100Medicaid
FLJD825ZOtherMEDICARE
FLP01982849OtherMEDICARE RAILROAD
FLSU92OOtherFL BLUE