Provider Demographics
NPI:1093820292
Name:MOSENKIS, ARI (MD)
Entity Type:Individual
Prefix:
First Name:ARI
Middle Name:
Last Name:MOSENKIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 UNION ST
Mailing Address - Street 2:STE 1800
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37219-2509
Mailing Address - Country:US
Mailing Address - Phone:216-261-6263
Mailing Address - Fax:
Practice Address - Street 1:25301 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44117-2609
Practice Address - Country:US
Practice Address - Phone:216-261-6263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN58836207RN0300X
OH35-086014207RN0300X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2626037Medicaid
OH2626037Medicaid
I27703Medicare UPIN