MEDICARE: HEEBA KALEEM 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
1	390200000X	Student in an Organized Health Care Education/Training Program
2	363A00000X	Physician Assistant	PA100793	MA

General Provider Information

NPI Number	:	1306579016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEEBA KALEEM PA-C

Provider Business Mailing Address
First Line	:	85 E INDIA ROW
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02110-3320
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13941 CEDAR RD
Second Line	:
City	:	SOUTH EUCLID
State	:	OH
Zip	:	44118-3203
Country	:	US
Telephone Number	:	216-412-9937
Fax Number	:	216-377-2217

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

Provider Enumeration Date	:	07/08/2022
Last Update Date	:	08/08/2025

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