Staszak, Colleen B

Staszak, Colleen B is an individual health care provider with primary practice located at 19800 Detroit Rd , Rocky River OH 44116-1884. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Staszak, Colleen B can be contacted via phone (440) 333-1107.

Contact Information

Primary practice address
19800 Detroit Rd Rocky River OH 44116-1884
Fax: (440) 333-1064
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 34-008120 Ohio

Profile Details

NPI number 1780651836
LBN Legal business name Staszak, Colleen B
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 7th, 2006
Last updated Jan 8th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780651836 NPPES
Ohio MEDICAID 2463516

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