Provider Demographics
NPI:1427855444
Name:HART, CARYN E (ISP, DSP)
Entity type:Individual
Prefix:
First Name:CARYN
Middle Name:E
Last Name:HART
Suffix:
Gender:
Credentials:ISP, DSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1256 E 143RD ST
Mailing Address - Street 2:
Mailing Address - City:EAST CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44112-2529
Mailing Address - Country:US
Mailing Address - Phone:216-673-9200
Mailing Address - Fax:
Practice Address - Street 1:1256 E 143RD ST
Practice Address - Street 2:
Practice Address - City:EAST CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-2529
Practice Address - Country:US
Practice Address - Phone:216-673-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH9966186373CH253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care