SG Medical Professional Services of Ohio Corp

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

SG MEDICAL PROFESSIONAL SERVICES OF OHIO CORP

Practice address

2660 Bishop Rd
Wickliffe, OH 44092-2642

Phone

(718) 362-1403

Fax

(718) 414-1651

NPI assigned

Jan 17, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Krystal McKenna

Title

Director of Operations

Phone

(718) 362-1403

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1673913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673913600000",
    "number": "1326753179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 CORPORATE WAY STE 2M",
            "city": "VALLEY COTTAGE",
            "state": "NY",
            "postal_code": "109892027",
            "telephone_number": "718-362-1403",
            "fax_number": "718-414-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2660 BISHOP RD",
            "city": "WICKLIFFE",
            "state": "OH",
            "postal_code": "440922642",
            "telephone_number": "718-362-1403",
            "fax_number": "718-414-1651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SG MEDICAL PROFESSIONAL SERVICES OF OHIO CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-17",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A",
        "authorized_official_last_name": "MCKENNA",
        "authorized_official_first_name": "KRYSTAL",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "718-362-1403"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sid E Savitt, O.D.
• Danardo Scarso, DDS
• Shelly Marie Schedler, CPM
• Meghann Schneider
• Lynette Scotese-Wojtila, OTR/L
• Samantha Shaw, PTA
• Matthew Stephen Sherlock, PA
• Sid Savitt, Inc.
• Barbara Sieger
• Signature Health, Inc.

• General Practice Physician in Wickliffe, OH
• Providers in Wickliffe, OH by specialty
• General Practice Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.