1093049900 NPI number — CLEVELAND CLINIC

Table of content: MRS. KIRSTIE LYNN MCFADDEN LCSW (NPI 1841430907)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093049900 NPI number — CLEVELAND CLINIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CLEVELAND CLINIC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1093049900
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/24/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9500 EUCLID AVE
Provider Second Line Business Mailing Address:
P21, DEPARTMENT OF PEDIATRIC ANESTHESIOLOGY
Provider Business Mailing Address City Name:
CLEVELAND
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44195-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-444-5996
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9500 EUCLID AVE
Provider Second Line Business Practice Location Address:
P21, DEPARTMENT OF PEDIATRIC ANESTHESIOLOGY
Provider Business Practice Location Address City Name:
CLEVELAND
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44195
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-444-5996
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/24/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KIMATIAN
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
Authorized Official Title or Position:
CHAIRMAN, PEDIATRIC ANESTHESIA
Authorized Official Telephone Number:
216-444-5996

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  35091798 , 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)