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General NPI Number Information
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NPI Number | 1588511646
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Entity Type | Organization
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Legal Business Name | CHRONIC CARE SPECIALISTS OF OHIO LLC
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Dates
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Enumeration Date | 03/16/2026
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Last Update Date | 03/16/2026
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Provider Practice Location Address
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Address Line | 3 GATEWAY
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City | EUCLID
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State | OH
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Zip | 44119-2447
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Country | US
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Telephone | 212-734-6621
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Fax |
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Provider Business Mailing Address
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Address Line | 1999 CEDARBRIDGE AVE STE 1A
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City | LAKEWOOD
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State | NJ
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Zip | 08701-7048
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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 | MANAGER
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Name | AKIVA WALDMAN
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Credential |
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Telephone | 848-223-8496
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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