Provider Demographics
NPI:1548964620
Name:ADZIMA, RANA (CNP)
Entity type:Individual
Prefix:
First Name:RANA
Middle Name:
Last Name:ADZIMA
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 MONETA AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:OH
Mailing Address - Zip Code:44202-9574
Mailing Address - Country:US
Mailing Address - Phone:216-570-6536
Mailing Address - Fax:
Practice Address - Street 1:20000 HARVARD AVE
Practice Address - Street 2:
Practice Address - City:WARRENSVILLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44122-6805
Practice Address - Country:US
Practice Address - Phone:216-491-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH10220164208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice