Provider Demographics
NPI:1851920821
Name:NORTHSHORE REHABILITATION MEDICINE
Entity Type:Organization
Organization Name:NORTHSHORE REHABILITATION MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:FLOOD
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:216-302-1500
Mailing Address - Street 1:26300 EUCLID AVE STE 333
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-3708
Mailing Address - Country:US
Mailing Address - Phone:216-302-1500
Mailing Address - Fax:216-302-1520
Practice Address - Street 1:26300 EUCLID AVE STE 333
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-3708
Practice Address - Country:US
Practice Address - Phone:216-302-1500
Practice Address - Fax:216-302-1520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1669813374OtherNPI