Dagostino, Gerald Joseph

Dagostino, Gerald Joseph is an individual health care provider with primary practice located at 5404 Northfield Road , Maple Hts OH 44137. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Dagostino, Gerald Joseph can be contacted via phone (216) 587-6620.

Contact Information

Primary practice address
5404 Northfield Road Maple Hts OH 44137
Phone: (216) 587-6620
Fax: (216) 587-6623
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 3716T397 Ohio

Profile Details

NPI number 1952314585
LBN Legal business name Dagostino, Gerald Joseph
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 14th, 2006
Last updated Jul 12th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952314585 NPPES
Ohio Other 341617718026 CARE SOURCE
Ohio MEDICAID 0632613 CARE SOURCE
Ohio Other 5369140001 CARE SOURCE

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