Basic Information
Provider Information
NPI: 1275795288
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DRESHAJ
FirstName: ALBANA
MiddleName:  
NamePrefix: MISS
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2351 EAST 22ND STREET
Address2: ST VINCENT CHARITY MEDICAL CTR
City: CLEVELAND
State: OH
PostalCode: 441152737
CountryCode: US
TelephoneNumber: 2163632538
FaxNumber: 2166944625
Practice Location
Address1: 2351 EAST 22ND STREET
Address2: ST VINCENT CHARITY MEDICAL CTR
City: CLEVELAND
State: OH
PostalCode: 441152737
CountryCode: US
TelephoneNumber: 2163632538
FaxNumber: 2166944625
Other Information
ProviderEnumerationDate: 06/30/2008
LastUpdateDate: 03/15/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X34.010007OHY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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