Basic Information
| Provider Information | |||||||||
| NPI: | 1689029530 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STYSKEL | ||||||||
| FirstName: | REINA | ||||||||
| MiddleName: | UCHINO | ||||||||
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| Credential: | MD | ||||||||
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| OtherLastName: | UCHINO | ||||||||
| OtherFirstName: | REINA | ||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 6000 W CREEK RD STE 20 | ||||||||
| Address2: | |||||||||
| City: | INDEPENDENCE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441312139 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2169861113 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 18101 LORAIN AVE | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441115612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2164767000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/28/2016 | ||||||||
| LastUpdateDate: | 09/07/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME141913 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | BP10056271 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 35.145040 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.