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NPI Code Detail

MEDICARE: DR. PATRICIA V GRODECKI M.D.

MEDICARE:  DR. PATRICIA V GRODECKI  M.D.
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
1207RC0000XCardiovascular Disease Physician39058KY

Other Identifiers

General Provider Information

NPI Number : 1992708069
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PATRICIA V GRODECKI M.D.
Provider Business Mailing Address
First Line : 6905 BURLINGTON PIKE
Second Line : SUITE E
City : FLORENCE
State : KY
Zip : 41042-1618
Country : US
Telephone Number : 859-282-0500
Fax Number : 859-282-7324
Provider Business Practice Location Address
First Line : 2139 AUBURN AVE
Second Line : BALDWIN BLDG. 5 SOUTH
City : CINCINNATI
State : OH
Zip : 45219-2906
Country : US
Telephone Number : 513-585-1954
Fax Number : 513-585-0607
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 03/21/2011

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Directions to “ DR. PATRICIA V GRODECKI M.D.” Practice Location

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