Basic Information
Provider Information
NPI: 1730357575
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MARRAWAY
FirstName: TERRY
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: ONDECHECK
OtherFirstName: TERRY
OtherMiddleName: L
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 951915
Address2:  
City: CLEVELAND
State: OH
PostalCode: 441930021
CountryCode: US
TelephoneNumber: 8003944445
FaxNumber: 7066501034
Practice Location
Address1: 320 E NORTH AVE
Address2:  
City: PITTSBURGH
State: PA
PostalCode: 152124756
CountryCode: US
TelephoneNumber: 8003944445
FaxNumber: 7066501034
Other Information
ProviderEnumerationDate: 02/14/2008
LastUpdateDate: 03/30/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XRN288948LPAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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