Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QG0300X | Family Doctor - Geriatric Medicine | 35.095658 | OH |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 51747 | KY |
NPI | 1245453059 |
---|---|
Provider Name | Mara Tomaszewski |
First Address | Ft. Mitchell, KY 41017-1673 |
Second Address | Fort Thomas, KY 41075-1793 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2007 |
Last Update Date | 05/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3086306 | (05) | OH |