MEDICARE: DR. ERIC S ELEFF MD

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	207W00000X	Ophthalmology Physician	35-05-8146-E	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376538421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC S ELEFF MD

Provider Business Mailing Address
First Line	:	2411 BLOSSOM LN
Second Line	:
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-1522
Country	:	US
Telephone Number	:	216-363-2467
Fax Number	:	216-696-2936

Provider Business Practice Location Address
First Line	:	1730 W 25TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-3108
Country	:	US
Telephone Number	:	216-363-2467
Fax Number	:	216-696-2936

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

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	08/05/2010

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