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Organization

SG MEDICAL PROFESSIONAL SERVICES OF OHIO CORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KRYSTAL MCKENNA (DIRECTOR OF OPERATIONS)
(718) 362-1403
Entity
Organization

Contact information

Practice address
2660 BISHOP RD, WICKLIFFE, OH 44092-2642
(718) 362-1403
(718) 414-1651
Mailing address
612 CORPORATE WAY STE 2M, VALLEY COTTAGE, NY 10989-2027
(718) 362-1403
(718) 414-1651

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary

Other

Enumeration date
01/17/2023
Last updated
01/17/2023
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