1649352055 NPI number — ANNE MARIE SALES NP / CNS

Table of content: ANNE MARIE SALES NP / CNS (NPI 1649352055)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649352055 NPI number — ANNE MARIE SALES NP / CNS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SALES
Provider First Name:
ANNE
Provider Middle Name:
MARIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NP / CNS
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:
1649352055
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 E 185TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EUCLID
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44119-1330
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-832-9703
Provider Business Mailing Address Fax Number:
216-227-9232

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 E 185TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EUCLID
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44119-1330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-832-9703
Provider Business Practice Location Address Fax Number:
216-227-9232
Provider Enumeration Date:
10/19/2006

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: 363LA2200X , with the licence number:  363LA2200X , 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: 2619045 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: NP04613 . This is a "NP LICENSE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: RN217991 . This is a "RN LICENSE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: NS01154 . This is a "CNS LICENSE NUMBER" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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