Individual
MRS. MARINA GRITSIK TUDICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
6780 MAYFIELD RD / HCS1-725, MAYFIELD HEIGHTS, OH 44124
(440) 312-6100
(440) 312-0454
Mailing address
6780 MAYFIELD RD # HCS1-725, MAYFIELD HEIGHTS, OH 44124-2203
(440) 312-6100
(440) 312-0454
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
002279
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200279
CONNECTICARE
CT
01
—
3V2764
HEALTHNET
CT
Enumeration date
07/20/2009
Last updated
08/19/2015
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