Provider Demographics
NPI:1528538568
Name:AL-NIMER, SARA (MS)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:AL-NIMER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 FATHER CARUSO DR APT 4105
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-1003
Mailing Address - Country:US
Mailing Address - Phone:440-670-6688
Mailing Address - Fax:
Practice Address - Street 1:5900 FATHER CARUSO DR APT 4105
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-1003
Practice Address - Country:US
Practice Address - Phone:440-670-6688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-03
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHTK773879171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHTK773879Medicaid