=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528924461
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GOLDIE J BARDO
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/05/2026
-----------------------------------------------------
Last Update Date | 01/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16986 INDIAN HOLLOW RD
-----------------------------------------------------
City | GRAFTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44044-9232
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-924-4670
-----------------------------------------------------
Fax | 216-924-4670
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16986 INDIAN HOLLOW RD
-----------------------------------------------------
City | GRAFTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44044-9232
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-924-4670
-----------------------------------------------------
Fax | 216-924-4670
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3747P1801X
-----------------------------------------------------
Taxonomy Name | Personal Care Attendant
-----------------------------------------------------
License Number | TH410530
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------