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General NPI Number Information
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NPI Number | 1952340812
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Entity Type | Organization
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Legal Business Name | NORTHEAST OHIO EMERGENCY AFFILIATES
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2639 WOOSTER RD
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City | ROCKY RIVER
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State | OH
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Zip | 44116-2911
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Country | US
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Telephone | 440-331-9520
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Fax | 440-331-9530
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Provider Business Mailing Address
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Address Line | 4700 ROCKSIDE RD SUITE 200
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City | INDEPENDENCE
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State | OH
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Zip | 44131-2155
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Country | US
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Telephone | 216-643-3000
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Fax | 216-643-3011
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Authorized Official
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Title or Position | OWNER
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Name | MRS. CARLA ODAY
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Credential | MD
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Telephone | 440-331-9520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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