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NPI Code Detail

MEDICARE: CLEVELAND SURGICAL ASSOCIATES, INC.

MEDICARE: CLEVELAND SURGICAL ASSOCIATES, INC.
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
1363L00000XNurse Practitioner

General Provider Information

NPI Number : 1831140003
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLEVELAND SURGICAL ASSOCIATES, INC.
Provider Business Mailing Address
First Line : 12301 RIDGE RD
Second Line :
City : NORTH ROYALTON
State : OH
Zip : 44133-3744
Country : US
Telephone Number : 440-652-8748
Fax Number : 440-582-3171
Provider Business Practice Location Address
First Line : 12301 RIDGE RD
Second Line :
City : NORTH ROYALTON
State : OH
Zip : 44133-3744
Country : US
Telephone Number : 440-652-8748
Fax Number : 440-582-3171
Authorized Official
Title or Position : EVP OPERATIONS
Name : MATTHEW LEGOWSKI
Credential :
Telephone Number : 609-703-5097
Provider Enumeration Date : 05/13/2006
Last Update Date : 03/28/2024

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