Healthcare Provider Details

I. General information

NPI: 1306999149
Provider Name (Legal Business Name): ELIZABETH SUSAN PAGANINI B.S.N,C.N.O.R,RNFA,
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18901 LAKE SHORE BLVD
EUCLID OH
44119-1078
US

IV. Provider business mailing address

18901 LAKE SHORE BLVD
EUCLID OH
44119-1078
US

V. Phone/Fax

Practice location:
  • Phone: 216-692-8920
  • Fax:
Mailing address:
  • Phone: 216-692-8920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0800X
TaxonomyOrthopedic Registered Nurse
License NumberRN.269297
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: