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General NPI Number Information
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NPI Number | 1811158173
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Entity Type | Individual
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Provider Name | KRYSTYNA MARIE KOLACZYNSKI M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/19/2008
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Last Update Date | 10/21/2013
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Provider Practice Location Address
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Address Line | 9500 EUCLID AVE FA20
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City | CLEVELAND
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State | OH
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Zip | 44195-0001
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Country | US
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Telephone | 216-444-2165
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Fax |
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Provider Business Mailing Address
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Address Line | 16300 VAN AKEN BLVD 202A
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City | SHAKER HEIGHTS
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State | OH
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Zip | 44120-5307
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Country | US
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Telephone | 216-862-7774
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084S0012X
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Taxonomy Name | Sleep Medicine (Psychiatry & Neurology) Physician
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License Number | 35. 121789
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License Number State | OH
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