Provider Demographics
NPI:1821123936
Name:LAKE ERIE NEPHROLOGY AND HYPERTENSION ASSOCIATES, INC
Entity Type:Organization
Organization Name:LAKE ERIE NEPHROLOGY AND HYPERTENSION ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ZAFAR
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-291-2123
Mailing Address - Street 1:2121 HUGHES DR
Mailing Address - Street 2:STE 630
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-3845
Mailing Address - Country:US
Mailing Address - Phone:419-291-2123
Mailing Address - Fax:419-291-6972
Practice Address - Street 1:2121 HUGHES DR
Practice Address - Street 2:STE 630
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3845
Practice Address - Country:US
Practice Address - Phone:419-291-2123
Practice Address - Fax:419-291-6972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHLA9356601Medicare PIN