MEDICARE: LILLIAN SEDACCA BAYER PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	50.005895RX	OH

General Provider Information

NPI Number	:	1265090757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LILLIAN SEDACCA BAYER PA-C

Provider Business Mailing Address
First Line	:	4894 BEECHWOOD RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45244-1239
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3801 HAUCK RD
Second Line	:
City	:	SHARONVILLE
State	:	OH
Zip	:	45241-4607
Country	:	US
Telephone Number	:	513-853-1040
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2019
Last Update Date	:	06/01/2022

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Directions to “ LILLIAN SEDACCA BAYER PA-C” Practice Location

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