Provider Demographics
NPI:1568641462
Name:AESTHETICS WITHIN, INC
Entity Type:Organization
Organization Name:AESTHETICS WITHIN, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:M
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-930-8187
Mailing Address - Street 1:32730 WALKER RD
Mailing Address - Street 2:SUITE F1
Mailing Address - City:AVON LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44012-4100
Mailing Address - Country:US
Mailing Address - Phone:440-930-8187
Mailing Address - Fax:440-930-7055
Practice Address - Street 1:32730 WALKER RD
Practice Address - Street 2:SUITE F1
Practice Address - City:AVON LAKE
Practice Address - State:OH
Practice Address - Zip Code:44012-4100
Practice Address - Country:US
Practice Address - Phone:440-930-8187
Practice Address - Fax:440-930-7055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-26
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35068585P208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2845489Medicaid
OH2845489Medicaid
OH9372891Medicare PIN