Provider Demographics
NPI:1386362754
Name:HAKEEM, SARA
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:HAKEEM
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 1:32542 SPRINGSIDE LN
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2063
Mailing Address - Country:US
Mailing Address - Phone:216-970-5137
Mailing Address - Fax:
Practice Address - Street 1:32542 SPRINGSIDE LN
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2063
Practice Address - Country:US
Practice Address - Phone:216-970-5137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH541OtherVETERANS ADMINISTRATION