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Individual

KENNETH A GIUSTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
3510 MANCHESTER RD, AKRON, OH 44319-1415
(330) 630-9699
(330) 644-0187
Mailing address
518 WEST AVE, TALLMADGE, OH 44278-2117
(330) 630-9699
(330) 630-2173

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5862-T2776
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000633789
ANTHEM
OH
05
2988343
OH
01
5862-T2776
OHIO LICENSE
OH
01
P00823294
RAILROAD MEDICARE
OH
Enumeration date
08/11/2009
Last updated
05/24/2012
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