Healthcare Provider Details

I. General information

NPI: 1538495130
Provider Name (Legal Business Name): ADRIANA RAISA KRYWIAK DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2009
Last Update Date: 06/08/2020
Certification Date: 06/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25200 CENTER RIDGE RD SUITE 2400
WESTLAKE OH
44145-4141
US

IV. Provider business mailing address

20525 CENTER RIDGE RD SUITE 220
ROCKY RIVER OH
44116-3437
US

V. Phone/Fax

Practice location:
  • Phone: 440-331-5190
  • Fax:
Mailing address:
  • Phone: 440-895-5056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number36003526
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number36.003526
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: