Healthcare Provider Details

I. General information

NPI: 1316130941
Provider Name (Legal Business Name): KSENIA N TONYUSHKINA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2007
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

11100 EUCLID AVE
CLEVELAND OH
44106-1716
US

V. Phone/Fax

Practice location:
  • Phone: 216-844-3661
  • Fax: 216-844-8900
Mailing address:
  • Phone: 216-844-3661
  • Fax: 216-844-8900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number35.145257
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: