Provider Demographics
NPI:1649236068
Name:NAFT, JONATHAN MICHAEL (LPO, LPED)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:MICHAEL
Last Name:NAFT
Suffix:
Gender:M
Credentials:LPO, LPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18933 HIGH POINT RD
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44023-5074
Mailing Address - Country:US
Mailing Address - Phone:440-285-5785
Mailing Address - Fax:440-285-5786
Practice Address - Street 1:13376 RAVENNA RD
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-9007
Practice Address - Country:US
Practice Address - Phone:440-285-5785
Practice Address - Fax:440-285-5786
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPO78; LPED391744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0161051Medicaid
OH0985340003Medicare ID - Type UnspecifiedMENTOR
OH0985340001Medicare ID - Type UnspecifiedCHARDON
OH0985340002Medicare ID - Type UnspecifiedASHTABULA