Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 57.030226 | OH |
NPI | 1003347873 |
---|---|
Provider Name | Laura Discenna |
First Address | Columbus, OH 43205-2664 |
Second Address | Akron, OH 44312-4022 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2017 |
Last Update Date | 21/04/2021 |