Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | 35-064926 | OH |
NPI | 1053406678 |
---|---|
Provider Name | Regina M Rosace |
First Address | Euclid, OH 44117-1714 |
Second Address | Cleveland, OH 44106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 02/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000027623 | ANTHEM (01) | OH |
000000221289 | UNISON (01) | OH |
000000526093 | ANTHEM (01) | OH |
1020967470001 | PA MEDICAID (01) | PA |
2018515 | (05) | OH |
2018515 | BCMH (01) | OH |
363965 | WELLCARE (01) | OH |
745965 | BUCKEYE (01) | OH |
801820 | AETNA (01) | OH |
G55033 | (02) | OH |