Healthcare Provider Details

I. General information

NPI: 1801774633
Provider Name (Legal Business Name): OLEKSANDRA YEZAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2025
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26600 RENAISSANCE PKWY
WARRENSVILLE HEIGHTS OH
44128-5795
US

IV. Provider business mailing address

6507 MARSOL RD. #326 MAYFIELD HTS.
CLEVELAND OH
44124
US

V. Phone/Fax

Practice location:
  • Phone: 216-329-8999
  • Fax:
Mailing address:
  • Phone: 440-214-5201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: