Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0300X | Geriatric Medicine | 86180 | OH |
Y | 207RH0002X | Hospice and Palliative Medicine | 86180 | OH |
NPI | 1093787160 |
---|---|
Provider Name | Erika D Brudzinski |
First Address | Cincinnati, OH 45249-1658 |
Second Address | Cincinnati, OH 45249-1658 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2006 |
Last Update Date | 02/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000488408 | ANTHEM BCBS (01) | OH |
2601723 | (05) | OH |
I38771 | (02) | OH |