MEDICARE: NADA TAYEH

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
1	367H00000X	Anesthesiologist Assistant	67.000277	OH

General Provider Information

NPI Number	:	1104276963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NADA TAYEH

Provider Business Mailing Address
First Line	:	18101 LORAIN AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44111-5612
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7831 HICKORY HILL LN
Second Line	:
City	:	PARMA
State	:	OH
Zip	:	44130-7664
Country	:	US
Telephone Number	:	216-376-9098
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2016
Last Update Date	:	06/13/2016

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Directions to “ NADA TAYEH ” Practice Location

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