Individual
IMAN ELTAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
8350 ARBOR SQUARE DR, MASON, OH 45040-5000
(513) 346-3399
Mailing address
8350 ARBOR SQUARE DR, MASON, OH 45040-5000
(513) 346-3399
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50002267
OH
363A00000X
Physician Assistant
PA890
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0077588
—
OH
05
—
0270943
—
OH
05
—
7100289930
—
KY
Enumeration date
05/18/2006
Last updated
08/14/2023
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