Healthcare Provider Details

I. General information

NPI: 1922354588
Provider Name (Legal Business Name): MRS. AIMI ZAJAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2012
Last Update Date: 07/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 LAKESIDE AVE E
CLEVELAND OH
44114-1158
US

IV. Provider business mailing address

25 S MEADOWCROFT DR
AKRON OH
44313-7259
US

V. Phone/Fax

Practice location:
  • Phone: 216-420-9403
  • Fax:
Mailing address:
  • Phone: 330-714-5377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number304036
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: