Hidradenitis Suppurativa Institute, LLC

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

037749 Issued in OH

Legal business name

HIDRADENITIS SUPPURATIVA INSTITUTE, LLC

Practice address

26908 Detroit Rd
Suite 103
Westlake, OH 44145-2398

Phone

(440) 249-0274

Fax

(440) 808-1606

NPI assigned

Jul 7, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Paul G Hazen, M.D.

Title

President

Phone

(440) 249-0274

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1309996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309996800000",
    "number": "1346537685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26908 DETROIT RD",
            "address_2": "SUITE 103",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441452398",
            "telephone_number": "440-249-0274",
            "fax_number": "440-808-1606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26908 DETROIT RD",
            "address_2": "SUITE 103",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441452398",
            "telephone_number": "440-249-0274",
            "fax_number": "440-808-1606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIDRADENITIS SUPPURATIVA INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-07",
        "last_updated": "2011-07-07",
        "status": "A",
        "authorized_official_last_name": "HAZEN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-249-0274",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "OH",
            "license": "037749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jazmin Lianna Hernandez
• Diane M Herron, BS MS BSN MSN CNP
• Grace Anastasia Herwig, RN, APN
• Michele Zelina Hiatt, R.D.,L.D.
• Kara Hibler, OTR L
• Amber L Hill, PH.D., LPCCS
• April Hill, RBT
• Holly Hill
• Regina Hill, MD
• Peyton Hines, RBT

• Procedural Dermatology Physician in Westlake, OH
• Providers in Westlake, OH by specialty
• Procedural Dermatology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2011; 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.