Provider Demographics
NPI:1528718335
Name:ABDULLAH'GREENE, IYONNA SADE
Entity type:Individual
Prefix:MS
First Name:IYONNA
Middle Name:SADE
Last Name:ABDULLAH'GREENE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 BEAR CREEK DR APT 228
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44146-2911
Mailing Address - Country:US
Mailing Address - Phone:216-235-6995
Mailing Address - Fax:
Practice Address - Street 1:11305 FOREST AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44104-4821
Practice Address - Country:US
Practice Address - Phone:216-417-8212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health