Provider Demographics
NPI:1326385329
Name:PARDON, ERIC DUANE (SW)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:DUANE
Last Name:PARDON
Suffix:
Gender:M
Credentials:SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 W 24TH ST
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44052-4438
Mailing Address - Country:US
Mailing Address - Phone:440-245-3344
Mailing Address - Fax:
Practice Address - Street 1:1412 W 24TH ST
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44052-4438
Practice Address - Country:US
Practice Address - Phone:440-245-3344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-10
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker