Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 35-095132 | OH |
NPI | 1063562924 |
---|---|
Provider Name | Dr. Brian M Varisco |
First Address | Cincinnati, OH 45229-3039 |
Second Address | Cincinnati, OH 45229-3039 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2007 |
Last Update Date | 20/07/2010 |