Healthcare Provider Details

I. General information

NPI: 1366071490
Provider Name (Legal Business Name): KENNETH LEVI AVNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2020
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6781 OAKWOOD RD
PARMA HEIGHTS OH
44130-3733
US

IV. Provider business mailing address

6781 OAKWOOD RD
PARMA HEIGHTS OH
44130-3733
US

V. Phone/Fax

Practice location:
  • Phone: 216-956-4434
  • Fax:
Mailing address:
  • Phone: 216-956-4434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.151815CTR
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: