MEDICARE: JULIE A JASKIEWICZ 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	208000000X	Pediatrics Physician	35063826	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598760233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE A JASKIEWICZ MD

Provider Business Mailing Address
First Line	:	5400 DUPONT CIR
Second Line	:	SUITE A
City	:	MILFORD
State	:	OH
Zip	:	45150-2793
Country	:	US
Telephone Number	:	513-576-7700
Fax Number	:	513-576-1020

Provider Business Practice Location Address
First Line	:	4627 AICHOLTZ RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45244-1447
Country	:	US
Telephone Number	:	513-753-2820
Fax Number	:	513-753-2824

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

Provider Enumeration Date	:	06/18/2005
Last Update Date	:	04/20/2018

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