Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 126806 | OH |
Y | 2080P0201X | Pediatric Allergist | 35.126806 | OH |
NPI | 1457610297 |
---|---|
Provider Name | Dr. Jaclyn Ann Bjelac |
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 | 14/05/2012 |
Last Update Date | 28/10/2021 |