MEDICARE: JUDY YAKUNICH M.A.,C.C.C.-A

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	231H00000X	Audiologist	A-01153	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00681449	OTHER	OH	MEDICARE RAILROAD PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851556047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDY YAKUNICH M.A.,C.C.C.-A

Provider Business Mailing Address
First Line	:	15299 BAGLEY RD STE 300
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44130-4809
Country	:	US
Telephone Number	:	440-816-5091
Fax Number	:

Provider Business Practice Location Address
First Line	:	15299 BAGLEY RD
Second Line	:	#300
City	:	CLEVELAND
State	:	OH
Zip	:	44130-4823
Country	:	US
Telephone Number	:	440-779-1112
Fax Number	:

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

Provider Enumeration Date	:	07/28/2008
Last Update Date	:	03/02/2022

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