=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538198106
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CATARACT EYE CENTER OF CLEVELAND, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/03/2006
-----------------------------------------------------
Last Update Date | 06/03/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 26300 EUCLID AVE SUITE 312
-----------------------------------------------------
City | EUCLID
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44132-3708
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-574-6199
-----------------------------------------------------
Fax | 216-325-0352
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 26300 EUCLID AVE SUITE 312
-----------------------------------------------------
City | EUCLID
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44132-3708
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-574-6199
-----------------------------------------------------
Fax | 216-325-0352
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRACTICE ADMINISTRATOR
-----------------------------------------------------
Name | MS. KATHLEEN ZAMPOUNIS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 216-574-6199
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------