Provider Demographics
NPI:1194433680
Name:ELSASS, MARTIN
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:
Last Name:ELSASS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1708 COLUMBIANA LISBON RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIANA
Mailing Address - State:OH
Mailing Address - Zip Code:44408-9441
Mailing Address - Country:US
Mailing Address - Phone:330-272-8574
Mailing Address - Fax:
Practice Address - Street 1:1708 COLUMBIANA LISBON RD
Practice Address - Street 2:
Practice Address - City:COLUMBIANA
Practice Address - State:OH
Practice Address - Zip Code:44408-9441
Practice Address - Country:US
Practice Address - Phone:330-272-8574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No171WH0202XOther Service ProvidersContractorHome Modifications
No171WV0202XOther Service ProvidersContractorVehicle Modifications
No172A00000XOther Service ProvidersDriver
No1744G0900XOther Service ProvidersSpecialistGraphics Designer
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker