1962248443 NPI number — MRS. SHOSHANAH CHAYA LEBOVITS LSW

Table of content: MRS. SHOSHANAH CHAYA LEBOVITS LSW (NPI 1962248443)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962248443 NPI number — MRS. SHOSHANAH CHAYA LEBOVITS LSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEBOVITS
Provider First Name:
SHOSHANAH
Provider Middle Name:
CHAYA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
POST
Provider Other First Name:
SHOSHANAH
Provider Other Middle Name:
CHAYA
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
LSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1962248443
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/03/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4298 SILSBY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
UNIVERSITY HEIGHTS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44118-3962
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-978-5069
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:
Provider Business Practice Location Address City Name:
CLEVELAND
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44195-0002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-363-2122
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/03/2024

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: 1041C0700X , with the licence number:  S.2410598 , 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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