Provider Demographics
NPI:1205123668
Name:JESTE, NEELUM (MD)
Entity type:Individual
Prefix:
First Name:NEELUM
Middle Name:
Last Name:JESTE
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 1:3333 BURNET AVE
Mailing Address - Street 2:MLC 7015
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-803-4738
Mailing Address - Fax:513-636-3549
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:MLC 7015
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-803-4738
Practice Address - Fax:513-636-3549
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-06
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011016850208000000X
OH1234232080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics