Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 35-096671 | OH |
N | 2080N0001X | Neonatal-Perinatal Doctor | MD2005-0081 | NM |
NPI | 1063497014 |
---|---|
Provider Name | Dr. Mary Elaine Patrinos |
First Address | Euclid, OH 44117-1714 |
Second Address | Cleveland, OH 44106-1716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2005 |
Last Update Date | 18/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3120769 | (05) | OH |
65655036 | (05) | NM |
G74793 | (02) |