Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35.124528 | OH |
Y | 2080P0205X | Pediatric Endocrinologist | 35.124528 | OH |
N | 2080P0205X | Pediatric Endocrinologist | 57-024002 | OH |
NPI | 1093121980 |
---|---|
Provider Name | Dr. Andrea Dawn Mucci |
First Address | Cleveland, OH 44195-0001 |
Second Address | Cleveland, OH 44195-1716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2014 |
Last Update Date | 01/11/2021 |