Basic Information
Provider Information | |||||||||
NPI: | 1295907731 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | VISHNIA & ASSOCIATES, INC. | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: | PROFESSIONAL NURSING SERVICE | ||||||||
OtherOrganizationType: | 3 | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 2497 STATE RD | ||||||||
Address2: |   | ||||||||
City: | CUYAHOGA FALLS | ||||||||
State: | OH | ||||||||
PostalCode: | 442231503 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3309295512 | ||||||||
FaxNumber: | 3309297732 | ||||||||
Practice Location | |||||||||
Address1: | 2497 STATE RD | ||||||||
Address2: |   | ||||||||
City: | CUYAHOGA FALLS | ||||||||
State: | OH | ||||||||
PostalCode: | 442231503 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3309295512 | ||||||||
FaxNumber: | 3309297732 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 03/25/2008 | ||||||||
LastUpdateDate: | 03/31/2008 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | VISHNIA | ||||||||
AuthorizedOfficialFirstName: | DIANE | ||||||||
AuthorizedOfficialMiddleName: | L | ||||||||
AuthorizedOfficialTitleorPosition: | CEO | ||||||||
AuthorizedOfficialTelephone: | 3309295512 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: | MSN, RN | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X |   | OH | Y |   | Agencies | Home Health |   |
ID Information
ID | Type | State | Issuer | Description | 0955659 | 05 | OH |   | MEDICAID |