Widjaja, Elysa

Widjaja, Elysa is an sole proprietor health care provider with primary practice located at 3333 Burnet Ave Ml 5031, Cincinnati OH 45229-3026. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Radiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Pediatric Radiology is her primary health care specialty. Widjaja, Elysa can be contacted via phone (513) 636-4251.

Contact Information

Primary practice address
3333 Burnet Ave Ml 5031 Cincinnati OH 45229-3026
Phone: (513) 636-4251
Fax: (513) 636-8145
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Radiology 2085P0229X 036.161747 Illinois
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 036161747 Illinois
Allopathic & Osteopathic Physicians / Pediatric Radiology 2085P0229X 35.155182 Ohio

Profile Details

NPI number 1184331522
LBN Legal business name Widjaja, Elysa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 4th, 2022
Last updated Feb 12th, 2026 - about 8 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers