Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35136841 | OH |
Y | 2080P0204X | Pediatric Emergency Doctor | 35136841 | OH |
NPI | 1235499922 |
---|---|
Provider Name | Dr. Rotem Elitsur-Fitzpatrick |
First Address | Columbus, OH 43205-2664 |
Second Address | Columbus, OH 43205-2664 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2012 |
Last Update Date | 27/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0159388 | (05) | OH |