Provider Demographics
NPI:1871473033
Name:GORODETSKIY, VERA (RN)
Entity type:Individual
Prefix:
First Name:VERA
Middle Name:
Last Name:GORODETSKIY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5332 SEBASTIAN CT
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-1941
Mailing Address - Country:US
Mailing Address - Phone:216-215-2472
Mailing Address - Fax:
Practice Address - Street 1:5332 SEBASTIAN CT
Practice Address - Street 2:
Practice Address - City:HIGHLAND HTS
Practice Address - State:OH
Practice Address - Zip Code:44143-1941
Practice Address - Country:US
Practice Address - Phone:216-215-2472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-06
Last Update Date:2025-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.297500163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health