Organization
CLEVELAND VASCULAR INSTITUTE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY A STANLEY D.O. (PHYSICIAN PRESIDENT)
(216) 991-2600
Entity
Organization
Contact information
Practice address
4100 WARRENSVILLE CENTER RD, SUITE 1002, WARRENSVILLE HEIGHTS, OH 44122-7024
(216) 991-2600
Mailing address
4100 WARRENSVILLE CENTER RD, SUITE 1002, WARRENSVILLE HEIGHTS, OH 44122-7024
(216) 991-2600
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2981144
—
OH
01
—
DA6647
RR MEDICARE
—
Enumeration date
01/30/2007
Last updated
06/08/2011
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