Provider Demographics
NPI:1174706170
Name:LENCOSKI, HEIDI D (MD)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:D
Last Name:LENCOSKI
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:PO BOX 636643
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6643
Mailing Address - Country:US
Mailing Address - Phone:440-989-3801
Mailing Address - Fax:440-960-0264
Practice Address - Street 1:5054 WATERFORD DR
Practice Address - Street 2:
Practice Address - City:SHEFFIELD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44035-1497
Practice Address - Country:US
Practice Address - Phone:440-934-8344
Practice Address - Fax:440-934-8345
Is Sole Proprietor?:No
Enumeration Date:2007-12-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35092835207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0236248Medicaid
OH2949475Medicaid
OH3025372Medicaid
OH3025372Medicaid
OH4285681Medicare PIN
OH9284951Medicare PIN