| New Pathways Clinic Llc | |
|
18660 Bagley Rd Ste 101 Middleburg Heights OH 44130-3483 | |
| (440) 973-8400 | |
| (440) 201-6400 |
| Full Name | New Pathways Clinic Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 18660 Bagley Rd Ste 101, Middleburg Heights, Ohio |
| Authorized Official Name and Position | Stephen Suntala (OWNER) |
| Authorized Official Contact | 4409738400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Pathways Clinic Llc 18660 Bagley Rd Ste 101 Middleburg Heights OH 44130-3483 Ph: (440) 973-8400 | New Pathways Clinic Llc 18660 Bagley Rd Ste 101 Middleburg Heights OH 44130-3483 Ph: (440) 973-8400 |
| NPI Number | 1619640414 |
|---|---|
| Provider Enumeration Date | 07/28/2021 |
| Last Update Date | 07/28/2021 |
| Certification Date | 07/28/2021 |
| Medicare PECOS PAC ID | 9436553716 |
|---|---|
| Medicare Enrollment ID | O20210809002387 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619640414 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Carla V Hart-tyner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134476088 PECOS PAC ID: 8224280938 Enrollment ID: I20121204000076 |
| Provider Name | Gabrielle C Delarose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801209119 PECOS PAC ID: 9830317700 Enrollment ID: I20140908000159 |
| Provider Name | Nora Finnegan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104276328 PECOS PAC ID: 8123300142 Enrollment ID: I20170126000619 |
| Provider Name | Tiffinne Perkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184981870 PECOS PAC ID: 6709252521 Enrollment ID: I20221019003234 |
| Provider Name | Sean Boyd |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1013798107 PECOS PAC ID: 9234587619 Enrollment ID: I20231122003263 |
| Provider Name | Kelly Liufen Liu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922781046 PECOS PAC ID: 8224488515 Enrollment ID: I20231228002980 |
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