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NPI Code Detail

MEDICARE: MARGIE ROSSANDER

MEDICARE:   MARGIE  ROSSANDER
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
1163WS0200XSchool Registered NurseRN273919OH

General Provider Information

NPI Number : 1699177618
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARGIE ROSSANDER
Provider Business Mailing Address
First Line : 2155 MIRAMAR BLVD
Second Line :
City : UNIVERSITY HEIGHTS
State : OH
Zip : 44118-3301
Country : US
Telephone Number : 216-320-4713
Fax Number : 216-397-5958
Provider Business Practice Location Address
First Line : 2530 CANTERBURY RD
Second Line :
City : CLEVELAND HEIGHTS
State : OH
Zip : 44118-4333
Country : US
Telephone Number : 216-320-4713
Fax Number : 216-397-5956
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2014
Last Update Date : 09/22/2014

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