Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 46995 | KY |
Y | 2080P0204X | Pediatric Emergency Doctor | 46995 | KY |
NPI | 1245559954 |
---|---|
Provider Name | Erika Pasciuta |
First Address | Louisville, KY 40201-0909 |
Second Address | Lexington, KY 40536-1821 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2010 |
Last Update Date | 30/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201264060 | (05) | IN |
7100311910 | (05) | KY |