Doctor Name: | TATYANA KLIGMAN |
NPI Number: | 1205297678 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | COA.18889-NP |
Business Practice Address: | 12300 Mccracken Rd Garfield Heights, OH - 441252914 |
Business Phone Number: | 2165810500 |
Business Fax Number: | |
Mailing Address: | 14569 Russell Ln, NOVELTY |
State: | OH |
Postal Code: | 440729528 |
Phone Number: | 4403387107 |
Fax Number: | |
NPI Enumeration Date: | 03/14/2016 |
NPI Last Update Date: | 03/14/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LG0600X |
License Number: | COA.18889-NP |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Gerontology |
Taxonomy Definition: |