Provider Demographics
NPI:1467741645
Name:CRYSTAL HEMATOLOGY AND ONCOLOGY LTD
Entity Type:Organization
Organization Name:CRYSTAL HEMATOLOGY AND ONCOLOGY LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WEI
Authorized Official - Middle Name:
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-513-6530
Mailing Address - Street 1:2184 ROCK CRK
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-4743
Mailing Address - Country:US
Mailing Address - Phone:216-513-6530
Mailing Address - Fax:330-659-7318
Practice Address - Street 1:6707 POWERS BLVD STE 302
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5470
Practice Address - Country:US
Practice Address - Phone:440-743-2590
Practice Address - Fax:440-743-2591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-29
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35082642261QX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH138714Medicare UPIN