Provider Demographics
NPI:1134580665
Name:SUROVI, ANDREA
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:SUROVI
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 1:281 SHIAWASSEE AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-3749
Mailing Address - Country:US
Mailing Address - Phone:330-217-1754
Mailing Address - Fax:
Practice Address - Street 1:524 W PARK AVE
Practice Address - Street 2:
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-2580
Practice Address - Country:US
Practice Address - Phone:330-753-1096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-10
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management