Provider Demographics
NPI:1609542232
Name:CARCIONE, JONATHAN
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:CARCIONE
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:UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER
Mailing Address - Street 2:11100 EUCLID AVENUE
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106
Mailing Address - Country:US
Mailing Address - Phone:216-844-1000
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER
Practice Address - Street 2:11100 EUCLID AVENUE
Practice Address - City:ATLANTA
Practice Address - State:OH
Practice Address - Zip Code:44106
Practice Address - Country:US
Practice Address - Phone:216-844-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2022-06-17
Deactivation Date:2022-03-18
Deactivation Code:
Reactivation Date:2022-04-05
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program