Basic Information
Provider Information
NPI: 1831521475
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MAFRICI
FirstName: JULIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: TAMONEY
OtherFirstName: JULIA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: CNP
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 74852
Address2:  
City: CLEVELAND
State: OH
PostalCode: 441944852
CountryCode: US
TelephoneNumber: 4408790081
FaxNumber: 4408790084
Practice Location
Address1: 29000 CENTER RIDGE RD
Address2:  
City: WESTLAKE
State: OH
PostalCode: 441455293
CountryCode: US
TelephoneNumber: 4408358000
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/06/2013
LastUpdateDate: 08/06/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2100XNP-14923OHY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


Home