Provider Demographics
NPI:1467678565
Name:HARDAWAY, CLAUDEINE
Entity Type:Individual
Prefix:MS
First Name:CLAUDEINE
Middle Name:
Last Name:HARDAWAY
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 1:1795 W 25TH ST
Mailing Address - Street 2:SUITE 1041
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-3112
Mailing Address - Country:US
Mailing Address - Phone:216-621-4356
Mailing Address - Fax:216-621-4356
Practice Address - Street 1:1795 W 25TH ST
Practice Address - Street 2:SUITE 1041
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-3112
Practice Address - Country:US
Practice Address - Phone:216-621-4356
Practice Address - Fax:216-621-4356
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH375604560596376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2717662Medicaid