Provider Demographics
NPI:1639621170
Name:FACIANA, DAVID P SR (CSCM)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:P
Last Name:FACIANA
Suffix:SR
Gender:M
Credentials:CSCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19342 BRADFORD CT
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44149-6070
Mailing Address - Country:US
Mailing Address - Phone:440-724-6573
Mailing Address - Fax:440-220-4507
Practice Address - Street 1:19342 BRADFORD CT
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44149-6070
Practice Address - Country:US
Practice Address - Phone:440-724-6573
Practice Address - Fax:440-220-4507
Is Sole Proprietor?:No
Enumeration Date:2016-11-01
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator