Provider Demographics
NPI:1902622947
Name:BLUE, AARON
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:BLUE
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 1:6015 SWEET BIRCH DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44146-3073
Mailing Address - Country:US
Mailing Address - Phone:216-773-2071
Mailing Address - Fax:
Practice Address - Street 1:5327 NORTHFIELD RD APT 122
Practice Address - Street 2:
Practice Address - City:BEDFORD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44146-1127
Practice Address - Country:US
Practice Address - Phone:216-773-2071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide