Healthcare Provider Details

I. General information

NPI: 1679922017
Provider Name (Legal Business Name): ROBERT USSAI PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2016
Last Update Date: 02/02/2021
Certification Date: 02/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6802 W SNOWVILLE RD STE B
BRECKSVILLE OH
44141-3296
US

IV. Provider business mailing address

340 SOUTH BROADWAY STREET
AKRON OH
44308
US

V. Phone/Fax

Practice location:
  • Phone: 216-831-6611
  • Fax: 216-831-2726
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.019784
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: