Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | 35.078694 | OH |
Y | 207RX0202X | Medical Oncology | MD424718 | PA |
NPI | 1124028667 |
---|---|
Provider Name | Dr. Kathryn Lorraine Faccini |
First Address | Youngstown, OH 44505-2245 |
Second Address | Youngstown, OH 44505-2245 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2005 |
Last Update Date | 13/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F39623 | (02) | PA |