Provider Demographics
NPI:1013431089
Name:TEMPFLI, SASHA
Entity Type:Individual
Prefix:
First Name:SASHA
Middle Name:
Last Name:TEMPFLI
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 1:456 FORDHAM PKWY
Mailing Address - Street 2:
Mailing Address - City:BAY VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44140-2912
Mailing Address - Country:US
Mailing Address - Phone:440-250-1530
Mailing Address - Fax:
Practice Address - Street 1:456 FORDHAM PKWY
Practice Address - Street 2:
Practice Address - City:BAY VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44140-2912
Practice Address - Country:US
Practice Address - Phone:440-250-1530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-01
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH107805649Medicaid