Saravanan Llc | |
630 E River St Elyria OH 44035-5902 | |
(440) 352-4321 | |
(440) 392-6193 |
Full Name | Saravanan Llc |
---|---|
Speciality | Psychiatry & Neurology |
Location | 630 E River St, Elyria, Ohio |
Authorized Official Name and Position | Balaji Saravanan (PRESIDENT) |
Authorized Official Contact | 4403524321 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Saravanan Llc Po Box 477 Avon OH 44011-0477 Ph: (440) 352-4321 | Saravanan Llc 630 E River St Elyria OH 44035-5902 Ph: (440) 352-4321 |
NPI Number | 1639419062 |
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Provider Enumeration Date | 02/21/2013 |
Last Update Date | 02/21/2013 |
Medicare PECOS PAC ID | 3779720743 |
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Medicare Enrollment ID | O20130510000326 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639419062 | NPI | - | NPPES |
2776509 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
Provider Name | Balaji Saravanan |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1538351358 PECOS PAC ID: 0345336293 Enrollment ID: I20071023000714 |
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