Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | D87536 | MD |
N | 2084N0402X | Child Neurologist | 35.130938 | OH |
NPI | 1346501863 |
---|---|
Provider Name | Dr. Christopher Michael Carosella |
First Address | Baltimore, MD 21236-4902 |
Second Address | Cincinnati, OH 45229 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2012 |
Last Update Date | 31/07/2020 |