Basic Information
| Provider Information | |||||||||
| NPI: | 1922565894 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RADJEN | ||||||||
| FirstName: | ALEKSANDRA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8577 CAMDEN CT | ||||||||
| Address2: | |||||||||
| City: | BROADVIEW HEIGHTS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441471784 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 10204 GRANGER RD | ||||||||
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| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441253106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2165812900 | ||||||||
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| ProviderEnumerationDate: | 02/26/2019 | ||||||||
| LastUpdateDate: | 02/26/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT017859 | OH | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.