Provider Demographics
NPI:1720097587
Name:CENTRAL OHIO ENDOCRINOLOGY
Entity Type:Organization
Organization Name:CENTRAL OHIO ENDOCRINOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:ROMI
Authorized Official - Middle Name:
Authorized Official - Last Name:BHASIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-864-9581
Mailing Address - Street 1:5965 E BROAD ST
Mailing Address - Street 2:SUITE 330
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-1562
Mailing Address - Country:US
Mailing Address - Phone:614-864-9581
Mailing Address - Fax:614-864-5649
Practice Address - Street 1:5965 E BROAD ST
Practice Address - Street 2:SUITE 330
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-1562
Practice Address - Country:US
Practice Address - Phone:614-864-9581
Practice Address - Fax:614-864-5649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-08-1117207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2339973Medicaid
OHDC0189OtherRAILROAD MEDICARE
OH2339973Medicaid