Provider Demographics
NPI:1326289075
Name:LITVAK, SVETLANA ALANA (CNP)
Entity Type:Individual
Prefix:MRS
First Name:SVETLANA
Middle Name:ALANA
Last Name:LITVAK
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23850 COMMERCE PARK
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5829
Mailing Address - Country:US
Mailing Address - Phone:440-753-6030
Mailing Address - Fax:440-568-5003
Practice Address - Street 1:23850 COMMERCE PARK
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5829
Practice Address - Country:US
Practice Address - Phone:440-753-6030
Practice Address - Fax:440-568-5003
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-10
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.06479-NP363L00000X
OHAPRN.CNP.024350363L00000X
OHRN275530163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0388047Medicaid