Individual
JONATHAN ALLAN JANICZEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3188 BELLEVUE AVE, CINCINNATI, OH 45219-2369
(513) 475-8000
(513) 584-0468
Mailing address
234 GOODMAN ST, ML 665X, CINCINNATI, OH 45219-2364
(513) 584-7425
(513) 584-7681
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
35.136418
OH
208M00000X
Hospitalist Physician
Primary
35136418
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/14/2015
Last updated
06/20/2023
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