Organization
CLEVELAND STATE UNIVERSITY HEALTH AND WELLNESS SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EILEEN GUTTMAN CNP (SUPERVISOR)
(216) 687-3649
Entity
Organization
Contact information
Practice address
2121 EUCLID AVE, UN 263, CLEVELAND, OH 44115-2214
(216) 687-3649
(216) 687-9319
Mailing address
2121 EUCLID AVE, UN 263, CLEVELAND, OH 44115-2214
(216) 687-3649
(216) 687-9319
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02-0251800
PHARM LICENSE #
OH
05
—
2329019
—
OH
01
—
36D0874476
CLIA
OH
Enumeration date
11/16/2005
Last updated
08/17/2018
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