Healthcare Provider Details

I. General information

NPI: 1659233583
Provider Name (Legal Business Name): ISIS BEY-CLARK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 11/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5250 TRANSPORTATION BLVD
GARFIELD HEIGHTS OH
44125-5326
US

IV. Provider business mailing address

5004 E 88TH ST
GARFIELD HEIGHTS OH
44125-2015
US

V. Phone/Fax

Practice location:
  • Phone: 216-463-3509
  • Fax:
Mailing address:
  • Phone: 216-463-3509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: