Healthcare Provider Details

I. General information

NPI: 1164279956
Provider Name (Legal Business Name): NU ORRA LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2024
Last Update Date: 05/01/2024
Certification Date: 04/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13535 DETROIT AVE STE 4
LAKEWOOD OH
44107-4625
US

IV. Provider business mailing address

PO BOX 367
NORTH OLMSTED OH
44070-0367
US

V. Phone/Fax

Practice location:
  • Phone: 216-673-4009
  • Fax:
Mailing address:
  • Phone: 216-673-4009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NURA ORRA
Title or Position: MEDICAL DOCTOR/OWNER
Credential: D.O.
Phone: 216-673-4009