Healthcare Provider Details

I. General information

NPI: 1982188181
Provider Name (Legal Business Name): TROY URBANO CDCA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2018
Last Update Date: 09/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 HUNTINGTON PARK DR
COLUMBUS OH
43235-5617
US

IV. Provider business mailing address

7400 HUNTINGTON PARK DR
COLUMBUS OH
43235-5617
US

V. Phone/Fax

Practice location:
  • Phone: 614-505-0378
  • Fax:
Mailing address:
  • Phone: 614-505-0378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: