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NPI Code Detail

MEDICARE: PAMELA A PERESTA

MEDICARE:   PAMELA A PERESTA
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
1163W00000XRegistered NurseRN.356266OH

General Provider Information

NPI Number : 1750696514
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAMELA A PERESTA
Provider Business Mailing Address
First Line : 1150 TOLLIS PKWY APT 214
Second Line :
City : BROADVIEW HTS
State : OH
Zip : 44147-1859
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1150 TOLLIS PKWY APT 214
Second Line :
City : BROADVIEW HTS
State : OH
Zip : 44147-1859
Country : US
Telephone Number : 440-679-9010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2010
Last Update Date : 08/17/2010

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Directions to “ PAMELA A PERESTA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.