Provider Demographics
NPI:1255934360
Name:JEFF, ANASTATIA
Entity type:Individual
Prefix:
First Name:ANASTATIA
Middle Name:
Last Name:JEFF
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 1:20000 LORAIN RD APT 221
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126-3459
Mailing Address - Country:US
Mailing Address - Phone:216-259-2455
Mailing Address - Fax:
Practice Address - Street 1:20000 LORAIN RD APT 221
Practice Address - Street 2:
Practice Address - City:FAIRVIEW PARK
Practice Address - State:OH
Practice Address - Zip Code:44126-3459
Practice Address - Country:US
Practice Address - Phone:216-259-2455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-19
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251J00000XAgenciesNursing Care
No172V00000XOther Service ProvidersCommunity Health Worker