MEDICARE: FASIHULLAH SADAT CPRS

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	175T00000X	Peer Specialist	APS.004379	OH

General Provider Information

NPI Number	:	1518746924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FASIHULLAH SADAT CPRS

Provider Business Mailing Address
First Line	:	2800 EUCLID AVE STE 200
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44115-2418
Country	:	US
Telephone Number	:	216-612-1179
Fax Number	:

Provider Business Practice Location Address
First Line	:	2800 EUCLID AVE STE 200
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44115-2418
Country	:	US
Telephone Number	:	216-612-1179
Fax Number	:

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

Provider Enumeration Date	:	09/25/2023
Last Update Date	:	09/25/2023

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Directions to “ FASIHULLAH SADAT CPRS” Practice Location

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