Provider Demographics
NPI:1609408608
Name:SCHWARTZ, DEVORA ELISHEVA
Entity Type:Individual
Prefix:
First Name:DEVORA
Middle Name:ELISHEVA
Last Name:SCHWARTZ
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 1:2150 MILTON RD APT 210
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-3946
Mailing Address - Country:US
Mailing Address - Phone:216-533-2513
Mailing Address - Fax:
Practice Address - Street 1:860 E BROAD ST STE I
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-6542
Practice Address - Country:US
Practice Address - Phone:440-323-8515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-07
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.434177367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered