Provider Demographics
NPI:1225689987
Name:NORTHERN OHIO PRACTITIONERS LLC
Entity Type:Organization
Organization Name:NORTHERN OHIO PRACTITIONERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KOUROSH
Authorized Official - Middle Name:
Authorized Official - Last Name:SAGHAFI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:440-842-8675
Mailing Address - Street 1:6681 RIDGE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-5705
Mailing Address - Country:US
Mailing Address - Phone:440-842-8675
Mailing Address - Fax:
Practice Address - Street 1:6681 RIDGE RD STE 300
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5705
Practice Address - Country:US
Practice Address - Phone:440-842-8675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-24
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty