1881917532 NPI number — GAIL ANN BUJORIAN RN, MSN, AOCNS

Table of content: LAKITA ALLEN MA, LPC (NPI 1265024277)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881917532 NPI number — GAIL ANN BUJORIAN RN, MSN, AOCNS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BUJORIAN
Provider First Name:
GAIL
Provider Middle Name:
ANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN, MSN, AOCNS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ZIMMERMAN
Provider Other First Name:
GAIL
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1881917532
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/06/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
155 5TH ST NE
Provider Second Line Business Mailing Address:
PARKVIEW CENTER
Provider Business Mailing Address City Name:
BARBERTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44203-3332
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-753-3583
Provider Business Mailing Address Fax Number:
330-753-3598

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
155 5TH ST NE
Provider Second Line Business Practice Location Address:
PARKVIEW CENTER
Provider Business Practice Location Address City Name:
BARBERTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44203-3332
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-753-3583
Provider Business Practice Location Address Fax Number:
330-753-3598
Provider Enumeration Date:
03/09/2010

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: 364SX0200X , with the licence number:  149602-COA1 , 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)





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