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General NPI Number Information
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NPI Number | 1821330937
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Entity Type | Individual
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Provider Name | JESSICA R GARUCCIO PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/27/2013
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Last Update Date | 01/14/2021
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Provider Practice Location Address
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Address Line | 1000 AUBURN DR # 210
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City | BEACHWOOD
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State | OH
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Zip | 44122-4317
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Country | US
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Telephone | 216-844-5595
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Fax | 216-844-5522
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Provider Business Mailing Address
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Address Line | 24701 EUCLID AVE THIRD FLOOR BILLING SERVICES
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City | EUCLID
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State | OH
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Zip | 44117-1714
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Country | US
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Telephone | 216-844-5595
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Fax | 216-844-5522
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 50.003710
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License Number State | OH
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