Individual
MR. ILYA VAISBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
2500 METROHEALTH DR, CLEVELAND, OH 44109-1900
(216) 778-7800
Mailing address
2500 METROHEALTH DR, CLEVELAND, OH 44109-1900
(330) 480-3258
(330) 480-4119
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN.CNP.0027287
OH
363LA2100X
Acute Care Nurse Practitioner
APRN.CNP.0027287
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0436034
—
OH
Enumeration date
01/22/2021
Last updated
11/06/2023
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