Individual
KAREN J BROCCO-KISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3511 CENTER RD, SUITE EC, BRUNSWICK, OH 44212-4426
(330) 273-4752
Mailing address
2550 SUBSTATION RD, MEDINA, OH 44256-8356
(330) 273-4752
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
35-03-8185-B
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0362594
—
OH
05
—
3052744
—
OH
Enumeration date
07/07/2006
Last updated
05/24/2015
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