MEDICARE: SUNITA DALSANIA LISW

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	104100000X	Social Worker		OH

General Provider Information

NPI Number	:	1811044993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUNITA DALSANIA LISW

Provider Business Mailing Address
First Line	:	26777 LORAIN ROAD #716
Second Line	:
City	:	NORTH OLMSTED
State	:	OH
Zip	:	44070
Country	:	US
Telephone Number	:	440-777-9200
Fax Number	:	440-777-9288

Provider Business Practice Location Address
First Line	:	26777 LORAIN RD STE 716
Second Line	:
City	:	NORTH OLMSTED
State	:	OH
Zip	:	44070-3221
Country	:	US
Telephone Number	:	440-777-9200
Fax Number	:	440-777-9288

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

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	07/08/2007

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Directions to “ SUNITA DALSANIA LISW” Practice Location

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