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General NPI Number Information
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NPI Number | 1003864240
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Entity Type | Individual
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Provider Name | DEBORAH J WILLNER P.A.
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Gender | Female
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 08/26/2024
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Provider Practice Location Address
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Address Line | 2150 W 117TH ST STE 1238
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City | CLEVELAND
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State | OH
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Zip | 44111-1641
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Country | US
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Telephone | 216-477-0071
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Fax | 216-957-8518
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Provider Business Mailing Address
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Address Line | 2150 W 117TH ST STE 1238
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City | CLEVELAND
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State | OH
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Zip | 44111-1641
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Country | US
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Telephone | 216-477-0071
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Fax | 216-957-8518
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 085000430
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License Number State | IL
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