1750487351 NPI number — MRS. ANN LIVINGSTON FARAH CNP

Table of content: KIMBERLY M ERSKINE LMT (NPI 1073645362)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750487351 NPI number — MRS. ANN LIVINGSTON FARAH CNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FARAH
Provider First Name:
ANN
Provider Middle Name:
LIVINGSTON
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CNP
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:
1750487351
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/08/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2323 WINFIELD AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCKY RIVER
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44116-2868
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440-356-4178
Provider Business Mailing Address Fax Number:
440-356-4178

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9500 EUCLID AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLEVELAND
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44195-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-223-2273
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/15/2006

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: 363LN0000X , with the licence number:  622 , 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: 00622 . This is a "CERTIFICATE TO PRESCRIBE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: RN 155480 . This is a "RN LICENSE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 622 . This is a "APN CERTIFICATE OF AUTHOR" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".