Provider Demographics
NPI:1942908884
Name:TEN, DORIS (LICENSED OPTICIAN)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:
Last Name:TEN
Suffix:
Gender:F
Credentials:LICENSED OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 CUNNINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-3270
Mailing Address - Country:US
Mailing Address - Phone:513-769-1184
Mailing Address - Fax:513-769-1264
Practice Address - Street 1:2801 CUNNINGHAM RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-3270
Practice Address - Country:US
Practice Address - Phone:513-769-1184
Practice Address - Fax:513-769-1264
Is Sole Proprietor?:No
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOP.004695-S156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician