Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225400000X | Rehabilitation Practitioner | ||
N | 225CA2400X | Assistive Technology Practitioner |
NPI | 1962827873 |
---|---|
Provider Name | Brian M Celusnak |
First Address | Cleveland Heights, OH 44118-1531 |
Second Address | Cleveland Heights, OH 44118-1531 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2014 |
Last Update Date | 01/05/2014 |