Provider Demographics
NPI:1699770784
Name:DINAR-KUSHNIR, YAEL (MD)
Entity type:Individual
Prefix:DR
First Name:YAEL
Middle Name:
Last Name:DINAR-KUSHNIR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25701 N LAKELAND BLVD STE 302
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-2452
Mailing Address - Country:US
Mailing Address - Phone:440-461-2421
Mailing Address - Fax:216-417-2912
Practice Address - Street 1:26701 LAKELAND BLVD STE 302
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132
Practice Address - Country:US
Practice Address - Phone:440-461-2421
Practice Address - Fax:216-417-2912
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH356983207WX0109X
OH35-063983207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0109XAllopathic & Osteopathic PhysiciansOphthalmologyNeuro-ophthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0549259Medicaid
OH0554609Medicaid
OHKU08915333Medicare PIN
OH0549259Medicaid
OH0891532Medicare PIN
OH0891537Medicare PIN