Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 35.123063 | OH |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 35.123063 | OH |
NPI | 1366732380 |
---|---|
Provider Name | Anna Goroncy |
First Address | Cincinnati, OH 45263-6256 |
Second Address | Cincinnati, OH 45219-2906 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2011 |
Last Update Date | 26/10/2015 |