SF Ohio Medical Services Corp

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SF OHIO MEDICAL SERVICES CORP

Practice address

1390 King Tree Dr
Dayton, OH 45405-1401

Phone

(718) 280-5436

Fax

(718) 362-1651

NPI assigned

Dec 20, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Simon Fensterszaub, MD

Title

Owner

Phone

(718) 362-1411

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1545264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552867200000",
    "number": "1073085676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 E ROUTE 59 # 408",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109542905",
            "telephone_number": "718-362-1411",
            "fax_number": "718-414-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 KING TREE DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454051401",
            "telephone_number": "718-280-5436",
            "fax_number": "718-362-1651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SF OHIO MEDICAL SERVICES CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-20",
        "last_updated": "2019-03-18",
        "status": "A",
        "authorized_official_last_name": "FENSTERSZAUB",
        "authorized_official_first_name": "SIMON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-362-1411",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zane Sexton
• David Scott Seymour, M.D.
• Jerrimia Joyann Seymour
• Nathanael Robert Seymour, ATC, CSCS
• Patrick Seymour
• John Sgro
• Mohamed Marawan Shabana, PHARMACIST
• Taheera Shabazz
• Carmela G Shackleford-Daniels, MSW, LSW
• Angela Shackleford

• Family Medicine Physician in Dayton, OH
• Providers in Dayton, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.