Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35087984 | OH |
Y | 2080P0208X | Pediatric Infectious Diseases | 087984 | OH |
NPI | 1679651699 |
---|---|
Provider Name | Christina Lancioni |
First Address | Portland, OR 97239-2901 |
Second Address | Portland, OR 97239-2901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 21/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000221093 | UNISON (01) | OH |
000000526063 | ANTHEM (01) | OH |
1020905740001 | PA MEDICAID (01) | PA |
2738881 | (05) | OH |
2738881 | BCMH (01) | OH |
363730 | WELLCARE (01) | OH |
750822 | BUCKEYE (01) | OH |
7757588 | AETNA (01) | OH |
I33612 | (02) |