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General NPI Number Information
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NPI Number | 1134119829
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Entity Type | Organization
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Legal Business Name | OUTREACH PROFESSIONAL SERVICES INC
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Dates
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Enumeration Date | 10/25/2005
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Last Update Date | 01/13/2021
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Provider Practice Location Address
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Address Line | 2351 E 22ND ST
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City | CLEVELAND
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State | OH
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Zip | 44115-3111
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Country | US
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Telephone | 216-363-2730
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 932127
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City | CLEVELAND
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State | OH
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Zip | 44193-0008
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SENIOR VICE PRESIDENT & CFO
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Name | JOHN RUSNACZYK
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Credential |
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Telephone | 216-363-7718
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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