Provider Demographics
NPI:1508556838
Name:COX, THANDEKA CHINYERE (BS, ED)
Entity Type:Individual
Prefix:
First Name:THANDEKA
Middle Name:CHINYERE
Last Name:COX
Suffix:
Gender:F
Credentials:BS, ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10620 EDGEPARK DR
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44125-2236
Mailing Address - Country:US
Mailing Address - Phone:216-420-3822
Mailing Address - Fax:
Practice Address - Street 1:10620 EDGEPARK DR
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44125-2236
Practice Address - Country:US
Practice Address - Phone:216-420-3822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)