| Saravanan Llc | |
|
630 E River St Elyria OH 44035-5902 | |
| (440) 352-4321 | |
| (440) 392-6193 |
| Full Name | Saravanan Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 630 E River St, Elyria, Ohio |
| Authorized Official Name and Position | Balaji Saravanan (PRESIDENT) |
| Authorized Official Contact | 4403524321 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Saravanan Llc Po Box 477 Avon OH 44011-0477 Ph: (440) 352-4321 | Saravanan Llc 630 E River St Elyria OH 44035-5902 Ph: (440) 352-4321 |
| NPI Number | 1639419062 |
|---|---|
| Provider Enumeration Date | 02/21/2013 |
| Last Update Date | 02/21/2013 |
| Medicare PECOS PAC ID | 3779720743 |
|---|---|
| Medicare Enrollment ID | O20130510000326 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639419062 | NPI | - | NPPES |
| 2776509 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Balaji Saravanan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538351358 PECOS PAC ID: 0345336293 Enrollment ID: I20071023000714 |
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