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Individual

JEFFREY L PONSKY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106
(216) 844-7874
Mailing address
3605 WARRENSVILLE CENTER RD, 1ST FLOOR, SHAKER HEIGHTS, OH 44122
(216) 286-6295
(216) 286-6341

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35035782
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000221283
UNISON
OH
01
000000503716
ANTHEM
OH
05
0309035
OH
01
363924
WELLCARE
OH
01
4077734
AETNA
OH
01
738086
BUCKEYE
OH
01
P00358838
RAILROAD MEDICARE
OH
Enumeration date
02/08/2006
Last updated
02/29/2008
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