Healthcare Provider Details

I. General information

NPI: 1255854667
Provider Name (Legal Business Name): NEWARK LEASING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2017
Last Update Date: 07/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 MCMILLEN DR
NEWARK OH
43055-1808
US

IV. Provider business mailing address

29225 CHAGRIN BLVD STE 230
CLEVELAND OH
44122-4632
US

V. Phone/Fax

Practice location:
  • Phone: 216-367-1214
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1706N
License Number StateOH

VIII. Authorized Official

Name: ELI M GUNZBURG
Title or Position: MANAGER
Credential:
Phone: 440-658-1040