| Elite Medical Practice, Llc | |
|
21851 Center Ridge Rd Ste 109 Rocky River OH 44116-3901 | |
| (440) 331-5488 | |
| (440) 331-3790 |
| Full Name | Elite Medical Practice, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 21851 Center Ridge Rd Ste 109, Rocky River, Ohio |
| Authorized Official Name and Position | Emile Sabbagh (MD/OWNER) |
| Authorized Official Contact | 4403315488 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Medical Practice, Llc Po Box 771508 Lakewood OH 44107-0060 Ph: (440) 331-5488 | Elite Medical Practice, Llc 21851 Center Ridge Rd Ste 109 Rocky River OH 44116-3901 Ph: (440) 331-5488 |
| NPI Number | 1730674037 |
|---|---|
| Provider Enumeration Date | 06/28/2018 |
| Last Update Date | 06/28/2018 |
| Medicare PECOS PAC ID | 9931458999 |
|---|---|
| Medicare Enrollment ID | O20180823003106 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730674037 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 35.082908 (Ohio) | Primary |
| Provider Name | Emile I Sabbagh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831165521 PECOS PAC ID: 6608846944 Enrollment ID: I20040726001413 |
| Provider Name | Laura C Pauley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639553191 PECOS PAC ID: 9436465978 Enrollment ID: I20150831000286 |
| Provider Name | Laura Gienke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295186757 PECOS PAC ID: 9638467350 Enrollment ID: I20161013000444 |
| Provider Name | Lori Donahue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518493410 PECOS PAC ID: 8426324195 Enrollment ID: I20171024003119 |
| Provider Name | Manjola Lamcaj |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598366197 PECOS PAC ID: 3375954993 Enrollment ID: I20201202002254 |
| Provider Name | Sydney A Bowen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881321396 PECOS PAC ID: 2466837380 Enrollment ID: I20220913003423 |
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