Provider Demographics
NPI:1508084815
Name:POCHEDLEY, ELLEN KATHLEEN
Entity Type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:KATHLEEN
Last Name:POCHEDLEY
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 1:1092 LEONARD BLVD
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-3356
Mailing Address - Country:US
Mailing Address - Phone:330-678-2777
Mailing Address - Fax:
Practice Address - Street 1:1092 LEONARD BLVD
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-3356
Practice Address - Country:US
Practice Address - Phone:330-678-2777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2475030Medicare ID - Type UnspecifiedINDEPENDENT PROVIDER #