1992943435 NPI number — GINA FRISZMAN

Table of content: GINA FRISZMAN (NPI 1992943435)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992943435 NPI number — GINA FRISZMAN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRISZMAN
Provider First Name:
GINA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992943435
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/21/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4710 STATE RD.
Provider Second Line Business Mailing Address:
THEAPY IN MOTION, LLC
Provider Business Mailing Address City Name:
CLEVELAND
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44109-9532
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-459-2846
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5273 BROADVIEW RD.
Provider Second Line Business Practice Location Address:
THE THERAPY LINK
Provider Business Practice Location Address City Name:
PARMA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44134
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-749-6650
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/21/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  COND.2008153-SP , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 08429945 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000217475 . This is a "ANTHEM BLUE CROSS AND BLUE SHIELD" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".