Healthcare Provider Details

I. General information

NPI: 1306993860
Provider Name (Legal Business Name): PILAR SARASA HUTTER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 03/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18101 LORAIN AVE
CLEVELAND OH
44111-5612
US

IV. Provider business mailing address

3340 ARCHWOOD DR
ROCKY RIVER OH
44116-3702
US

V. Phone/Fax

Practice location:
  • Phone: 216-476-7052
  • Fax:
Mailing address:
  • Phone: 440-356-1436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN197205
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: