Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35066489 | OH |
Y | 2080A0000X | Adolescent Medicine | 35066489 | OH |
NPI | 1134184104 |
---|---|
Provider Name | Dr. Ellen S Rome |
First Address | Cleveland, OH 44195-0001 |
Second Address | Cleveland, OH 44195-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2006 |
Last Update Date | 03/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0997435 | (05) | OH |
F79488 | (02) | OH |