Basic Information
Provider Information
NPI: 1114418423
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAHA
FirstName: BRITTANY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 333 N SUMMIT ST FL 7
Address2:  
City: TOLEDO
State: OH
PostalCode: 436041531
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 3316 NAVARRE AVE STE F
Address2:  
City: OREGON
State: OH
PostalCode: 436163301
CountryCode: US
TelephoneNumber: 4192911420
FaxNumber: 4192143841
Other Information
ProviderEnumerationDate: 05/22/2018
LastUpdateDate: 07/26/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/26/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X  Y Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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