Provider Demographics
NPI:1437894862
Name:NUCERINO, ALEX
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:NUCERINO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6503 COACH LIGHT CIR
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TWP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-1356
Mailing Address - Country:US
Mailing Address - Phone:513-503-6744
Mailing Address - Fax:
Practice Address - Street 1:6503 COACH LIGHT CIR
Practice Address - Street 2:
Practice Address - City:LIBERTY TWP
Practice Address - State:OH
Practice Address - Zip Code:45011-1356
Practice Address - Country:US
Practice Address - Phone:513-503-6744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-30
Last Update Date:2022-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program