Healthcare Provider Details

I. General information

NPI: 1497260251
Provider Name (Legal Business Name): JENNA CIOFANI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2017
Last Update Date: 12/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9220 MENTOR AVE
MENTOR OH
44060-6412
US

IV. Provider business mailing address

9220 MENTOR AVE
MENTOR OH
44060-6412
US

V. Phone/Fax

Practice location:
  • Phone: 440-639-3581
  • Fax: 440-205-1009
Mailing address:
  • Phone: 440-639-3581
  • Fax: 440-205-1009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: