Provider Demographics
NPI:1518120666
Name:EINK, MARY
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:
Last Name:EINK
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 1:19140 TANGLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NORTH ROYALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44133-5988
Mailing Address - Country:US
Mailing Address - Phone:440-582-3173
Mailing Address - Fax:
Practice Address - Street 1:19140 TANGLEWOOD DR
Practice Address - Street 2:
Practice Address - City:NORTH ROYALTON
Practice Address - State:OH
Practice Address - Zip Code:44133-5988
Practice Address - Country:US
Practice Address - Phone:440-582-3173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-265712163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse