MEDICARE: GINA MACCARONE 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	208600000X	Surgery Physician	35.099438	OH

General Provider Information

NPI Number	:	1730474917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GINA MACCARONE MD

Provider Business Mailing Address
First Line	:	7880 FINLEY LN
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45242-7308
Country	:	US
Telephone Number	:	513-218-4882
Fax Number	:

Provider Business Practice Location Address
First Line	:	4012 HARRISON AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-4627
Country	:	US
Telephone Number	:	513-400-4750
Fax Number	:

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

Provider Enumeration Date	:	06/15/2011
Last Update Date	:	09/24/2024

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