Doctor Name: | JENNIFER MARY COLIADIS |
NPI Number: | 1023252988 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | |
Business Practice Address: | 13201 Granger Rd Ste 2 Garfield Hts, OH - 441251979 |
Business Phone Number: | 2164758844 |
Business Fax Number: | 2164753816 |
Mailing Address: | 24701 Euclid Ave, Third Floor - Billing Services EUCLID |
State: | OH |
Postal Code: | 441171714 |
Phone Number: | 2164758844 |
Fax Number: | 2164753816 |
NPI Enumeration Date: | 04/22/2009 |
NPI Last Update Date: | 09/24/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OH |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |