Provider Demographics
NPI:1114509668
Name:QAIMARI, MONA
Entity Type:Individual
Prefix:
First Name:MONA
Middle Name:
Last Name:QAIMARI
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 1:1015 WILDERNESS CT
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-6260
Mailing Address - Country:US
Mailing Address - Phone:419-376-2299
Mailing Address - Fax:
Practice Address - Street 1:1015 WILDERNESS CT
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-6260
Practice Address - Country:US
Practice Address - Phone:419-376-2299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-24
Last Update Date:2021-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care