Healthcare Provider Details

I. General information

NPI: 1912940636
Provider Name (Legal Business Name): ANKITA PATEL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. ANKITA CHOKSHI

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 03/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25000 COUNTRY CLUB BLVD #255
NORTH OLMSTED OH
44070-5344
US

IV. Provider business mailing address

25000 COUNTRY CLUB BLVD #255
NORTH OLMSTED OH
44070-5344
US

V. Phone/Fax

Practice location:
  • Phone: 440-893-0200
  • Fax: 440-793-7194
Mailing address:
  • Phone: 440-893-0200
  • Fax: 440-793-7194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number003811
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberCOA.10853-NP
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number085124
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: