MEDICARE: DR. JOSHUA PATICOFF 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	207LP2900X	Pain Medicine (Anesthesiology) Physician	234358	NY
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	35.130894	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	:	1639190499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSHUA PATICOFF MD

Provider Business Mailing Address
First Line	:	600 CROSS POINTE RD STE A
Second Line	:
City	:	GAHANNA
State	:	OH
Zip	:	43230-6696
Country	:	US
Telephone Number	:	513-725-2186
Fax Number	:

Provider Business Practice Location Address
First Line	:	4355 FERGUSON DR STE 270
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45245-5137
Country	:	US
Telephone Number	:	513-718-0115
Fax Number	:	513-718-0116

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

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	07/21/2022

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