Provider Demographics
NPI:1376648683
Name:CARDIOVASCULAR IMAGING ASSOCIATES, LLC
Entity Type:Organization
Organization Name:CARDIOVASCULAR IMAGING ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:EMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SALLOUHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-356-6666
Mailing Address - Street 1:PO BOX 450615
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-0611
Mailing Address - Country:US
Mailing Address - Phone:440-356-6666
Mailing Address - Fax:440-356-6651
Practice Address - Street 1:20997 LORAIN RD
Practice Address - Street 2:
Practice Address - City:FAIRVIEW PARK
Practice Address - State:OH
Practice Address - Zip Code:44126-2030
Practice Address - Country:US
Practice Address - Phone:440-356-6666
Practice Address - Fax:440-356-6651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-071087207RC0000X, 207RI0011X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty