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General NPI Number Information
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NPI Number | 1518748821
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Entity Type | Individual
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Provider Name | BRENDAN MICHAEL CUMMINGS
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Gender | Male
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Dates
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Enumeration Date | 10/12/2023
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 13201 GRANGER RD
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City | GARFIELD HEIGHTS
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State | OH
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Zip | 44125-1978
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Country | US
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Telephone | 440-668-6615
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Fax |
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Provider Business Mailing Address
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Address Line | 3912 WINTON PARK DR
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City | NORTH OLMSTED
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State | OH
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Zip | 44070-1878
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Country | US
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Telephone | 440-668-6615
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Fax |
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | UM889205
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License Number State | OH
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