Provider Demographics
NPI:1336526839
Name:PILEKIC, TOMISLAV
Entity Type:Individual
Prefix:
First Name:TOMISLAV
Middle Name:
Last Name:PILEKIC
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 1:36 PUBLIC SQ # 15
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-7864
Mailing Address - Country:US
Mailing Address - Phone:440-549-0708
Mailing Address - Fax:
Practice Address - Street 1:36 PUBLIC SQ # 15
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-7864
Practice Address - Country:US
Practice Address - Phone:440-549-0708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-04
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT.008932225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH008932OtherOTPTAT BOARD