MEDICARE: ALFREDA D TRACY

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	246Y00000X	Health Information Specialist/Technologist
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1568333664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALFREDA D TRACY

Provider Business Mailing Address
First Line	:	1881 GRASMERE AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44112-3411
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	14902 EUCLID AVE
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44112-3408
Country	:	US
Telephone Number	:	440-339-3917
Fax Number	:

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

Provider Enumeration Date	:	09/13/2025
Last Update Date	:	09/13/2025

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Directions to “ ALFREDA D TRACY ” Practice Location

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