Provider Demographics
NPI:1013650910
Name:COLE, DENNIS MARCEL
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:MARCEL
Last Name:COLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 SUPERIOR AVE E STE 1618
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44114-2709
Mailing Address - Country:US
Mailing Address - Phone:216-412-7995
Mailing Address - Fax:
Practice Address - Street 1:1665 EDDINGTON RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44118-1158
Practice Address - Country:US
Practice Address - Phone:216-412-7995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant