1063455467 NPI number — DR. LAURA LEE SADLER AU.D

Table of content: AMBER D HERRING P.A.-C. (NPI 1679555346)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063455467 NPI number — DR. LAURA LEE SADLER AU.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SADLER
Provider First Name:
LAURA
Provider Middle Name:
LEE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
AU.D
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SOLTISZ
Provider Other First Name:
LAURA
Provider Other Middle Name:
LEE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1063455467
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/07/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7251 ENGLE RD
Provider Second Line Business Mailing Address:
SUITE 110
Provider Business Mailing Address City Name:
MIDDLEBURG HTS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44130
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440-234-5515
Provider Business Mailing Address Fax Number:
440-234-5540

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7251 ENGLE RD
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
MIDDLEBURG HTS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44130
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
440-234-5515
Provider Business Practice Location Address Fax Number:
440-234-5540
Provider Enumeration Date:
06/14/2006

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: 231HA2400X , with the licence number:  A0388 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 231HA2500X , with the licence number: A-0388 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 237600000X , with the licence number: A-0388 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 231H00000X , with the licence number: A-0388 , 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: 141905278 . This is a "TRICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 107283 . This is a "KAISER PERMANENTE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1905278028 . This is a "CARE SOURCE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2466264 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9122640 . This is a "CIGNA HEALTHCARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0007902648 . This is a "AETNA USHEALTHCARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000331371 . This is a "ANTHEM BC AND BS" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".