Healthcare Provider Details

I. General information

NPI: 1255147047
Provider Name (Legal Business Name): KAYLA ZAVAGE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2024
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4504 GAMMA AVE
NEWBURGH HTS OH
44105-3162
US

IV. Provider business mailing address

4504 GAMMA AVE
NEWBURGH HTS OH
44105-3162
US

V. Phone/Fax

Practice location:
  • Phone: 216-429-0219
  • Fax:
Mailing address:
  • Phone: 216-429-0219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: