Healthcare Provider Details

I. General information

NPI: 1558020032
Provider Name (Legal Business Name): BRACHA RUTH SENDERS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2021
Last Update Date: 12/13/2021
Certification Date: 12/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2054 S GREEN RD
SOUTH EUCLID OH
44121-4243
US

IV. Provider business mailing address

2489 BEACHWOOD BLVD
BEACHWOOD OH
44122-1546
US

V. Phone/Fax

Practice location:
  • Phone: 216-903-0786
  • Fax:
Mailing address:
  • Phone: 216-903-0786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number348763
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: