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2475 E 22nd St Fl 4 Cleveland OH 44115-3209 | |
| (216) 363-2570 | |
| (216) 363-7065 |
| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2475 E 22nd St Fl 4, Cleveland, Ohio |
| Authorized Official Name and Position | Theresa Wrabel (FINANCE DIRECTOR) |
| Authorized Official Contact | 2163633000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 932004 Cleveland OH 44193-0007 Ph: () - | 2475 E 22nd St Fl 4 Cleveland OH 44115-3209 Ph: (216) 363-2570 |
| NPI Number | 1902529985 |
|---|---|
| Provider Enumeration Date | 09/23/2022 |
| Last Update Date | 01/16/2025 |
| Certification Date | 01/16/2025 |
| Medicare PECOS PAC ID | 2860535978 |
|---|---|
| Medicare Enrollment ID | O20100626000223 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902529985 | NPI | - | NPPES |
| Provider Name | Jeffrey A Biro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992706410 PECOS PAC ID: 8224927199 Enrollment ID: I20040311000079 |
| Provider Name | Mukul G Pandit |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104815554 PECOS PAC ID: 2668422486 Enrollment ID: I20050128000339 |
| Provider Name | Charles J Garven |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568442861 PECOS PAC ID: 5991726374 Enrollment ID: I20051213000547 |
| Provider Name | Leslie Hensley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457435943 PECOS PAC ID: 1557263589 Enrollment ID: I20090310000555 |
| Provider Name | Brandy Mckinney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114232873 PECOS PAC ID: 3072638840 Enrollment ID: I20100916000815 |
| Provider Name | Ronald Manning |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356672836 PECOS PAC ID: 1355533357 Enrollment ID: I20101008000785 |
| Provider Name | Abu Nasir Syed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902909500 PECOS PAC ID: 9830082064 Enrollment ID: I20120126000436 |
| Provider Name | Laurel A Ralston |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417190281 PECOS PAC ID: 6204095607 Enrollment ID: I20120305000162 |
| Provider Name | Youssef Mahfoud |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467626572 PECOS PAC ID: 9638321920 Enrollment ID: I20121213000200 |
| Provider Name | Neal E Goldenberg |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114186418 PECOS PAC ID: 4981832474 Enrollment ID: I20140107001339 |
| Provider Name | Edward Kilbane |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225287410 PECOS PAC ID: 1456527431 Enrollment ID: I20150310001312 |
| Provider Name | Joseph Fernando Keppler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932627825 PECOS PAC ID: 0648546531 Enrollment ID: I20171020000223 |
| Provider Name | Fiovdaliza Volenik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225543051 PECOS PAC ID: 2466712872 Enrollment ID: I20180202002157 |
| Provider Name | Mary Wills |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497203053 PECOS PAC ID: 3072867167 Enrollment ID: I20181107003229 |
| Provider Name | Aaron Michael Geissinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255988192 PECOS PAC ID: 3678907433 Enrollment ID: I20200102002533 |
| Provider Name | Rajalla Prewitt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770644064 PECOS PAC ID: 1850448440 Enrollment ID: I20210812003218 |
| Provider Name | Desiree Darton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245774405 PECOS PAC ID: 5698140127 Enrollment ID: I20230413002523 |
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