Individual
ELISHAH SUSANNE GREENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9500 EUCLID AVE # RK2-7, CLEVELAND, OH 44195-0001
(216) 346-9605
(216) 636-5956
Mailing address
9500 EUCLID AVE # RK2-7, CLEVELAND, OH 44195-0001
(216) 346-9605
(216) 636-5956
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
500004525RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0155623
—
OH
Enumeration date
01/20/2016
Last updated
08/25/2021
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