1497910681 NPI number — NICOLETTA PUTATURO M.A.,C.C.C.-A

Table of content: NICOLETTA PUTATURO M.A.,C.C.C.-A (NPI 1497910681)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497910681 NPI number — NICOLETTA PUTATURO M.A.,C.C.C.-A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PUTATURO
Provider First Name:
NICOLETTA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.A.,C.C.C.-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:
1497910681
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/18/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 638269
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45263-8269
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440-816-5091
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15299 BAGLEY RD STE 300
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:
44130-4809
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
440-816-5091
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/28/2008

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: 231H00000X , with the licence number:  A-01066 , 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: 2085541 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0972309 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00681444 . This is a "MEDICARE RAILROAD PTAN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2085550 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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