Healthcare Provider Details

I. General information

NPI: 1811920721
Provider Name (Legal Business Name): ROSANNE M RADZIEWICZ PCNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 METROHEALTH DR MHMC-PSYCHIATRY
CLEVELAND OH
44109-1900
US

IV. Provider business mailing address

2500 METROHEALTH DR MHMC-PSYCHIATRY
CLEVELAND OH
44109-1900
US

V. Phone/Fax

Practice location:
  • Phone: 216-778-4120
  • Fax:
Mailing address:
  • Phone: 216-778-4120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberNS2152
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: