Provider Demographics
NPI:1861504185
Name:SANII, KAMROOZ (MD)
Entity Type:Individual
Prefix:
First Name:KAMROOZ
Middle Name:
Last Name:SANII
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:PO BOX 636930
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6930
Mailing Address - Country:US
Mailing Address - Phone:513-981-5123
Mailing Address - Fax:513-981-5015
Practice Address - Street 1:770 W HIGH ST
Practice Address - Street 2:SUITE 350
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-3990
Practice Address - Country:US
Practice Address - Phone:419-228-8950
Practice Address - Fax:419-224-7904
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY144905-1208800000X
OH35089090208800000X
VA0101249677208800000X
KY48668208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00637187Medicaid
NYB71675Medicare UPIN
NY082821Medicare ID - Type Unspecified