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General NPI Number Information
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NPI Number | 1437686102
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Entity Type | Organization
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Legal Business Name | GASTROENTEROLOGY ASSOCIATES OF CLEVELAND, INC.
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Dates
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Enumeration Date | 05/12/2017
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Last Update Date | 05/12/2017
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Provider Practice Location Address
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Address Line | 3700 PARK EAST DR STE 100
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City | BEACHWOOD
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State | OH
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Zip | 44122-4339
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Country | US
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Telephone | 216-593-7180
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Fax |
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Provider Business Mailing Address
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Address Line | 3700 PARK EAST DR STE 100
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City | BEACHWOOD
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State | OH
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Zip | 44122-4339
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Country | US
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Telephone | 216-593-7180
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Fax |
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MR. JAMES J ANDRASSY
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Credential | M.ED., PA-C
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Telephone | 216-593-7180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.020447
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License Number State | OH
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