Basic Information
| Provider Information | |||||||||
| NPI: | 1568569259 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GANDIONCO | ||||||||
| FirstName: | ELMER | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 411 OAK ST | ||||||||
| Address2: | STERLING MEDICAL ASSOCIATES ATTN: CREDENTIALS | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452192598 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5139844909 | ||||||||
| FaxNumber: | 5139844909 | ||||||||
| Practice Location | |||||||||
| Address1: | 411 OAK ST | ||||||||
| Address2: | STERLING MEDICAL ASSOCIATES | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452192598 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5139841800 | ||||||||
| FaxNumber: | 5139844909 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/17/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.