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NPI Code Detail

MEDICARE: CARMELA ANN SEVERINO PA-C

MEDICARE: CARMELA ANN SEVERINO PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant50.004614RXOH

General Provider Information

NPI Number : 1093176125
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARMELA ANN SEVERINO PA-C
Provider Business Mailing Address
First Line : 2915 LOST NATION RD
Second Line :
City : WILLOUGHBY
State : OH
Zip : 44094-7670
Country : US
Telephone Number : 440-567-4227
Fax Number :
Provider Business Practice Location Address
First Line : 2049 E 100TH ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-2104
Country : US
Telephone Number : 800-223-2273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2016
Last Update Date : 03/17/2016

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Directions to “ CARMELA ANN SEVERINO PA-C” Practice Location

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