Provider Demographics
NPI:1194120873
Name:VASSAR, CARMI
Entity type:Individual
Prefix:
First Name:CARMI
Middle Name:
Last Name:VASSAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1367 SHEFFIELD RD
Mailing Address - Street 2:FRONT
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3649
Mailing Address - Country:US
Mailing Address - Phone:216-297-9616
Mailing Address - Fax:
Practice Address - Street 1:1367 SHEFFIELD RD
Practice Address - Street 2:FRONT
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-3649
Practice Address - Country:US
Practice Address - Phone:216-297-9616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400848421208376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide