Provider Demographics
NPI:1437306792
Name:SIRACUSA MAJZUN, CARINA MARIE (PT)
Entity Type:Individual
Prefix:DR
First Name:CARINA
Middle Name:MARIE
Last Name:SIRACUSA MAJZUN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:DR
Other - First Name:CARINA
Other - Middle Name:MARIE
Other - Last Name:SIRACUSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 1267
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-6267
Mailing Address - Country:US
Mailing Address - Phone:614-850-0500
Mailing Address - Fax:614-850-0540
Practice Address - Street 1:5551 HILLIARD ROME OFFICE PARK
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-7287
Practice Address - Country:US
Practice Address - Phone:614-850-0500
Practice Address - Fax:614-850-0540
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT.011183225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH11900757OtherCAQH
OH11900757OtherCAQH