Healthcare Provider Details

I. General information

NPI: 1598173668
Provider Name (Legal Business Name): ALEXANDRIA NOTARO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2014
Last Update Date: 03/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2181 AMBLESIDE DR
CLEVELAND OH
44106-4645
US

IV. Provider business mailing address

2181 AMBLESIDE DR
CLEVELAND OH
44106-4645
US

V. Phone/Fax

Practice location:
  • Phone: 216-791-2968
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT.008327
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: