Healthcare Provider Details

I. General information

NPI: 1245717255
Provider Name (Legal Business Name): ASYA SHADEED-BEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2018
Last Update Date: 07/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5955 RIDGE RD
PARMA OH
44129-3936
US

IV. Provider business mailing address

5556 BROADVIEW RD APT 3126
PARMA OH
44134-1620
US

V. Phone/Fax

Practice location:
  • Phone: 440-888-0300
  • Fax:
Mailing address:
  • Phone: 216-903-0847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: