EDNA J DYCOCO (NPI# 1629153119) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629153119 |
| Entity Type | Individual |
| Full Name | EDNA J DYCOCO |
| Credential | MD |
| Practice Address |
64979 Old Twenty On Road Cambridge OH 43725-9619 |
| Practice Telephone | 7404326628 |
| Practice Fax Number | 7404325531 |
| Mailing Telephone | 7404326628 |
| Mailing Fax Number | 7404325531 |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 129969 | NY | Allopathic & Osteopathic Physicians |
| Y | 208000000X | Pediatrics | 35056228 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UNITED HEALTHCARE | 1200145 | 01 | |
| HEALTH PLAN | C0006228 | 01 | |
| OH | 0803885 | 05 | |
| AETNA | 1001723 | 01 | |
| ANTHEM | 000000153673 | 01 |
| Street Address |
64979 OLD TWENTY ON ROAD |
| City | CAMBRIDGE |
| State | OH |
| Zip Code | 43725-9619 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346849619 | Judith Olden | Home Health Aide | 807 N7th St., Cambridge, OH 43725 | 2020-10-19 |
| 1215419676 | Zak Harper | Student in an Organized Health Care Education/Training Program | 4245 College Hill Road, Cambridge, OH 43725 | 2018-09-02 |
| 1184133720 | Nancy Lou Mcintire | Counselor | 927 Wheeling Ave Suite 310, Cambridge, OH 43725 | 2017-09-27 |
| 1356877559 | Jane Engott | Counselor | 841 Stubenville Ave, Cambridge, OH 43725 | 2017-05-08 |
| 1316470701 | Kendra Winland | Case Management | 841 Steubenville Ave., Cambridge, OH 43725 | 2017-04-04 |
| 1609319870 | Candi Frame | Social Worker | 225 Woodlawn Ave, Cambridge, OH 43725 | 2016-11-21 |
| 1659727808 | William Andrew Kuebler | Pharmacist | 61690 Southgate Pkwy, Cambridge, OH 43725 | 2016-05-06 |
| 1790176758 | Res-care Ohio, Inc. | Intermediate Care Facility, Mentally Retarded | 503 Columbia Court, Cambridge, OH 43725 | 2015-02-12 |
| 1508257569 | Res-care Ohio, Inc. | Intermediate Care Facility, Mentally Retarded | 66620 Westgate Drive, Cambridge, OH 43725 | 2015-02-12 |
| 1558773432 | Altens Womens Health, LLC | Obstetrics & Gynecology | 65007 Old 21 Rd, Cambridge, OH 43725 | 2014-05-27 |
| Find all providers in zip 43725 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255878922 | Jean C Kelley, Md | Pediatrics | 61 Fresh Pond Pkwy, Cambridge, MA 02138-3348 | 2017-01-19 |
| 1922493774 | Amy W Fan | Pediatrics | 575 Mount Auburn St Ste 202, Cambridge, MA 02138-4627 | 2015-03-30 |
| 1912343260 | Mary P Alexander | Pediatrics | 799 Concord Ave # 4, Cambridge, MA 02138-1048 | 2013-05-14 |
| 1053624452 | Gina Exantus-bernard | Pediatrics | 400 Byrn St Ste A, Cambridge, MD 21613 | 2010-07-14 |
| 1336260587 | Charles J Homer | Pediatrics | Nichq, 20 University Road, Cambridge, MA 02138 | 2007-04-03 |
| 1770609844 | Phyllis J Wagner | Pediatrics | 4 Crawford St, Cambridge, MA 02139-1624 | 2007-03-21 |
| 1083743967 | Brian L Hamilton | Pediatrics | Merimack Pharmaceuticals, 101 Binney Street, Cambridge, MA 02142 | 2007-03-05 |
| 1497881239 | Erin Margaret Mahony | Pediatrics | 799 Concord Avenue, Belmont Cambridge Health Care, Cambridge, MA 02138 | 2007-02-26 |
| 1073662037 | Julia Fowler Aquino | Pediatrics | 110 2nd St Ph 15, Cambridge, MA 02141-2147 | 2007-01-09 |
| 1982717302 | Suresh Chandra Prabhudas Thakker | Pediatrics | 1420 Clark St, Cambridge, OH 43725-9617 | 2006-08-17 |
| Find all providers in CAMBRIDGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.