Provider Demographics
NPI:1053312298
Name:KRASNYANSKY, INNA (MD)
Entity Type:Individual
Prefix:DR
First Name:INNA
Middle Name:
Last Name:KRASNYANSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6803 MAYFIELD RD
Mailing Address - Street 2:STE 409 BLDG 1
Mailing Address - City:MAYFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124
Mailing Address - Country:US
Mailing Address - Phone:440-946-4662
Mailing Address - Fax:440-946-4084
Practice Address - Street 1:6803 MAYFIELD RD STE 409
Practice Address - Street 2:
Practice Address - City:MAYFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44124-2214
Practice Address - Country:US
Practice Address - Phone:440-946-4662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35076087207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2166105Medicaid
OH2316224OtherAETNA-LIFE & CASUALTY
OH000000142148OtherUNICARE-LIFE & HEALTH
OH000000142148OtherANTHEM BCBS
OHG99026Medicare UPIN
OH000000142148OtherUNICARE-LIFE & HEALTH
OH110234351Medicare PIN