Provider Demographics
NPI:1336383124
Name:JANISZEWSKI, DAVID MATTHEW (CNP)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:MATTHEW
Last Name:JANISZEWSKI
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11100 EUCLID AVE
Mailing Address - Street 2:MAIL STOP LKS 5035
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1716
Mailing Address - Country:US
Mailing Address - Phone:216-844-5770
Mailing Address - Fax:216-844-1202
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:MAIL STOP LKS 5035
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-5770
Practice Address - Fax:216-844-1202
Is Sole Proprietor?:No
Enumeration Date:2009-04-24
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHRN.346093-COA1163WG0000X
OHCOA.10549-NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice