Provider Demographics
NPI:1275128365
Name:WEISENBERGER, CARA
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:WEISENBERGER
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 1:20050 HARVARD AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:WARRENSVILLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-6816
Mailing Address - Country:US
Mailing Address - Phone:216-491-6045
Mailing Address - Fax:
Practice Address - Street 1:20050 HARVARD AVE FL 3
Practice Address - Street 2:
Practice Address - City:WARRENSVILLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44122-6816
Practice Address - Country:US
Practice Address - Phone:216-491-6045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03233778183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist