Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | OS012538 | PA |
NPI | 1043229750 |
---|---|
Provider Name | Erica Grazioli |
First Address | Erie, PA 16507-1578 |
Second Address | Erie, PA 16507-1578 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 09/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I62346 | (02) | PA |