Provider Demographics
NPI:1144377805
Name:FUNCTIONAL PERSONNEL
Entity Type:Organization
Organization Name:FUNCTIONAL PERSONNEL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:O
Authorized Official - Last Name:KUZMYN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-272-5244
Mailing Address - Street 1:4104 W RIDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44134-4116
Mailing Address - Country:US
Mailing Address - Phone:888-272-5244
Mailing Address - Fax:888-272-5245
Practice Address - Street 1:4104 W RIDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44134-4116
Practice Address - Country:US
Practice Address - Phone:888-272-5244
Practice Address - Fax:888-272-5245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health