Provider Demographics
NPI:1568757078
Name:SIHA, MARO M (RPH)
Entity Type:Individual
Prefix:MISS
First Name:MARO
Middle Name:M
Last Name:SIHA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:MARO
Other - Middle Name:S
Other - Last Name:GEORGE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:1595 E CROSSINGS PL
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-6224
Mailing Address - Country:US
Mailing Address - Phone:818-618-6610
Mailing Address - Fax:
Practice Address - Street 1:1595 E CROSSINGS PL
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-6224
Practice Address - Country:US
Practice Address - Phone:818-618-6610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-13
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03230828-2183500000X
CA61410183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist