Provider Demographics
NPI:1831308741
Name:PILJAN-GENTLE, ALYSSA A (MD)
Entity Type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:A
Last Name:PILJAN-GENTLE
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 1:3666 PAXTON AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-1568
Mailing Address - Country:US
Mailing Address - Phone:513-871-0684
Mailing Address - Fax:513-871-0705
Practice Address - Street 1:3666 PAXTON AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45208-1568
Practice Address - Country:US
Practice Address - Phone:513-871-0684
Practice Address - Fax:513-871-0705
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2015-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH89493208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics