Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35.098585 | OH |
Y | 2080P0214X | Pediatric Pulmonologist | 35.098585 | OH |
NPI | 1497081830 |
---|---|
Provider Name | Dr. Christopher Michael Siracusa |
First Address | Cincinnati, OH 45229-3026 |
Second Address | Cincinnati, OH 45229-3026 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2009 |
Last Update Date | 15/07/2015 |