Individual
DR. SANDRA J LACIVITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, CNM
Contact information
Practice address
8300 HOUGH AVENUE, CLEVELAND, OH 44103-4247
(216) 231-7700
(216) 231-3828
Mailing address
8300 HOUGH AVENUE, CLEVELAND, OH 44103-4247
(216) 231-7700
(216) 231-7920
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
NM1786
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0896197
—
OH
Enumeration date
05/02/2006
Last updated
11/20/2015
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