MEDICARE: JORDAN GUY SAROUKHAN

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	376J00000X	Homemaker
2	372600000X	Adult Companion

General Provider Information

NPI Number	:	1730805433
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORDAN GUY SAROUKHAN

Provider Business Mailing Address
First Line	:	4886 W STREETSBORO RD
Second Line	:
City	:	RICHFIELD
State	:	OH
Zip	:	44286-9560
Country	:	US
Telephone Number	:	216-240-4457
Fax Number	:

Provider Business Practice Location Address
First Line	:	3916 HYDE AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44109-1328
Country	:	US
Telephone Number	:	216-240-4457
Fax Number	:

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

Provider Enumeration Date	:	10/13/2022
Last Update Date	:	10/13/2022

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Directions to “ JORDAN GUY SAROUKHAN ” Practice Location

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