Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 000937 | OH |
NPI | 1083704092 |
---|---|
Provider Name | Lydia S Pawlyszyn |
First Address | N Royalton, OH 44133-1425 |
Second Address | Middleburg Heights, OH 44130-3417 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 28/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000217474 | ANTHEM BLUE CROSS AND BLU (01) | OH |
0842995 | (05) | OH |
OH4655A | BEECH STREET CORPORATION (01) |