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General NPI Number Information
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NPI Number | 1538675731
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Entity Type | Organization
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Legal Business Name | ACCESSNP
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Dates
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Enumeration Date | 12/26/2017
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Last Update Date | 02/15/2023
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Provider Practice Location Address
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Address Line | 5807 BRIDGE AVE
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City | CLEVELAND
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State | OH
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Zip | 44102-3114
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Country | US
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Telephone | 330-221-5494
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Fax |
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Provider Business Mailing Address
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Address Line | 5807 BRIDGE AVE
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City | CLEVELAND
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State | OH
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Zip | 44102-3114
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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 | OWNER
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Name | MATTHEW DVORAK
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Credential | CNP
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Telephone | 330-221-5494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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