Provider Demographics
NPI:1093035404
Name:DANIELA SUSOIU TCACIUC INC
Entity Type:Organization
Organization Name:DANIELA SUSOIU TCACIUC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:DENA
Authorized Official - Middle Name:
Authorized Official - Last Name:ORMSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-235-8484
Mailing Address - Street 1:4758 RIDGE RD
Mailing Address - Street 2:161
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44144-3327
Mailing Address - Country:US
Mailing Address - Phone:440-235-8484
Mailing Address - Fax:440-235-8440
Practice Address - Street 1:6681 RIDGE RD
Practice Address - Street 2:SUITE 400
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5713
Practice Address - Country:US
Practice Address - Phone:440-743-2450
Practice Address - Fax:440-743-2451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35080835-S207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty