MEDICARE: ALLIANCE HEALTHCARE BRAEVIEW, INC.

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	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1982928933
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIANCE HEALTHCARE BRAEVIEW, INC.

Provider Business Mailing Address
First Line	:	20611 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44117-1521
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	20611 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44117-1521
Country	:	US
Telephone Number	:	216-486-9300
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ELI GUNZBURG
Credential	:
Telephone Number	:	216-486-9300

Provider Enumeration Date	:	03/19/2010
Last Update Date	:	03/19/2010

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