Provider Demographics
NPI:1649948613
Name:REIDY, NADYA E
Entity type:Individual
Prefix:MS
First Name:NADYA
Middle Name:E
Last Name:REIDY
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:NADYA
Other - Middle Name:E
Other - Last Name:REIDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1463 HOPKINS AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-5020
Mailing Address - Country:US
Mailing Address - Phone:440-213-4248
Mailing Address - Fax:
Practice Address - Street 1:25201 CHAGRIN BLVD STE 390
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5637
Practice Address - Country:US
Practice Address - Phone:216-910-9015
Practice Address - Fax:216-910-9015
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-02
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty