Provider Demographics
NPI:1184755506
Name:KORTYKA, ALICE ANN (MA-FAAA)
Entity type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:ANN
Last Name:KORTYKA
Suffix:
Gender:F
Credentials:MA-FAAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 E APPLE GATE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245-7040
Mailing Address - Country:US
Mailing Address - Phone:513-843-6923
Mailing Address - Fax:513-232-2999
Practice Address - Street 1:7691 FIVE MILE RD
Practice Address - Street 2:SUITE 305
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-4100
Practice Address - Country:US
Practice Address - Phone:513-233-9560
Practice Address - Fax:513-232-2999
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA00741231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000202310OtherAUDIOLOGIST
OH000000241762OtherAUDIOLOGIST- HEARING AID