1013539659 NPI number — MRS. MARY CATHERINE SARKIS P.A.

Table of content: MRS. MARY CATHERINE SARKIS P.A. (NPI 1013539659)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013539659 NPI number — MRS. MARY CATHERINE SARKIS P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SARKIS
Provider First Name:
MARY
Provider Middle Name:
CATHERINE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
P.A.
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:
1013539659
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/27/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2000 AUBURN DR
Provider Second Line Business Mailing Address:
STE 350
Provider Business Mailing Address City Name:
BEACHWOOD
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44122-4327
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440-646-1600
Provider Business Mailing Address Fax Number:
440-646-1505

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6820 RIDGE RD
Provider Second Line Business Practice Location Address:
STE 204
Provider Business Practice Location Address City Name:
CUYAHOGA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44129-5647
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
440-845-1146
Provider Business Practice Location Address Fax Number:
440-845-4023
Provider Enumeration Date:
05/16/2020

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: 363A00000X , with the licence number:  50.007005RX , 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: 0464069 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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