MEDICARE: MARGARET SIVAKOFF RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WP2201X	Ambulatory Care Registered Nurse	127289	OH

General Provider Information

NPI Number	:	1275957045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET SIVAKOFF RN

Provider Business Mailing Address
First Line	:	2155 MIRAMAR BLVD
Second Line	:
City	:	UNIVERSITY HEIGHTS
State	:	OH
Zip	:	44118-3301
Country	:	US
Telephone Number	:	216-320-4854
Fax Number	:	216-320-5601

Provider Business Practice Location Address
First Line	:	2323 WRENFORD RD
Second Line	:
City	:	UNIVERSITY HEIGHTS
State	:	OH
Zip	:	44118-3902
Country	:	US
Telephone Number	:	216-320-4854
Fax Number	:	216-320-5601

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2014
Last Update Date	:	02/13/2014

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