Provider Demographics
NPI:1043564339
Name:MAGURA, VASYL (RN LNHA)
Entity Type:Individual
Prefix:
First Name:VASYL
Middle Name:
Last Name:MAGURA
Suffix:
Gender:M
Credentials:RN LNHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4527 LONGWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44134-3817
Mailing Address - Country:US
Mailing Address - Phone:440-915-7226
Mailing Address - Fax:440-888-7105
Practice Address - Street 1:4527 LONGWOOD AVE
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44134-3817
Practice Address - Country:US
Practice Address - Phone:440-915-7226
Practice Address - Fax:440-888-7105
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-08
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.421922163W00000X, 163W00000X, 163WA2000X, 163WC1500X, 163WI0600X, 163WR0400X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WI0600XNursing Service ProvidersRegistered NurseInfection ControlGroup - Multi-Specialty
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitationGroup - Multi-Specialty
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0075282Medicaid