Organization
NORTHEAST OHIO PRACTITIONER LLC
Active
Organization
NORTHEAST OHIO PRACTITIONER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KOUROSH SAGHAFI DO (PRESIDENT)
(216) 842-8675
Entity
Organization
Contact information
Practice address
6681 RIDGE RD STE 300, PARMA, OH 44129-5705
(440) 842-8675
(440) 842-1299
Mailing address
6681 RIDGE RD STE 300, PARMA, OH 44129-5705
(440) 842-8675
(440) 842-1299
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
4171215
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4171215
BUSINESS LICENSE
OH
Enumeration date
06/04/2018
Last updated
03/13/2019
Update your record
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