MEDICARE: KATYA SRACIC MD

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	390200000X	Student in an Organized Health Care Education/Training Program
2	208000000X	Pediatrics Physician	35.152757	OH

General Provider Information

NPI Number	:	1336880616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATYA SRACIC MD

Provider Business Mailing Address
First Line	:	240 ALBERT SABIN WAY
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45229-2842
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	240 ALBERT SABIN WAY
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45229-2842
Country	:	US
Telephone Number	:	513-636-4744
Fax Number	:

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

Provider Enumeration Date	:	04/02/2022
Last Update Date	:	09/18/2025

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Directions to “ KATYA SRACIC MD” Practice Location

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