| Westlake America Clinic Llc | |
|
25125 Detroit Rd Ste 100 Westlake OH 44145-2500 | |
| (216) 293-0282 | |
| (440) 455-9757 |
| Full Name | Westlake America Clinic Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 25125 Detroit Rd Ste 100, Westlake, Ohio |
| Authorized Official Name and Position | Abdelrahman Abdelaziz (OWNER) |
| Authorized Official Contact | 2162930282 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Westlake America Clinic Llc 25125 Detroit Rd Ste 100 Westlake OH 44145-2500 Ph: (216) 293-0282 | Westlake America Clinic Llc 25125 Detroit Rd Ste 100 Westlake OH 44145-2500 Ph: (216) 293-0282 |
| NPI Number | 1033752852 |
|---|---|
| Provider Enumeration Date | 10/24/2019 |
| Last Update Date | 04/12/2024 |
| Certification Date | 04/12/2024 |
| Medicare PECOS PAC ID | 9830523414 |
|---|---|
| Medicare Enrollment ID | O20200108000033 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033752852 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Teresa D Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265890164 PECOS PAC ID: 3577861467 Enrollment ID: I20160408001310 |
| Provider Name | Tara L Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821118530 PECOS PAC ID: 3870846611 Enrollment ID: I20181128003282 |
| Provider Name | Abdelrahman Abdelaziz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871960930 PECOS PAC ID: 9931453032 Enrollment ID: I20190531002068 |
| Provider Name | Rachel Saleh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629795158 PECOS PAC ID: 5496123010 Enrollment ID: I20221201001486 |
| Provider Name | Colleen K. Russell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053192104 PECOS PAC ID: 3274976881 Enrollment ID: I20240212001227 |
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