Provider Demographics
NPI:1841276276
Name:KUSHNIR, ORI (MD)
Entity type:Individual
Prefix:
First Name:ORI
Middle Name:
Last Name:KUSHNIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25701 N LAKELAND BLVD STE 302
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-2452
Mailing Address - Country:US
Mailing Address - Phone:440-461-2421
Mailing Address - Fax:216-417-2912
Practice Address - Street 1:25701 N LAKELAND BLVD STE 302
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-2452
Practice Address - Country:US
Practice Address - Phone:440-461-2421
Practice Address - Fax:440-461-2047
Is Sole Proprietor?:No
Enumeration Date:2005-12-18
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35061766207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0841147Medicaid
OH4013027Medicare PIN
OHF33493Medicare UPIN