Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35.137485 | OH |
N | 208000000X | Pediatrician | ME127644 | FL |
Y | 2080P0207X | Pediatric Hematology-Oncologist | 35.137485 | OH |
N | 2080P0207X | Pediatric Hematology-Oncologist | ME127644 | FL |
NPI | 1255545265 |
---|---|
Provider Name | Dr. Matteo Trucco |
First Address | Cleveland, OH 44195-1029 |
Second Address | Cleveland, OH 44195-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2007 |
Last Update Date | 29/10/2021 |