Provider Demographics
NPI:1033615661
Name:SZABO, TREVA
Entity Type:Individual
Prefix:
First Name:TREVA
Middle Name:
Last Name:SZABO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-3128
Mailing Address - Country:US
Mailing Address - Phone:937-743-9949
Mailing Address - Fax:
Practice Address - Street 1:840 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:45005-3128
Practice Address - Country:US
Practice Address - Phone:937-743-9949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2925366Medicaid