Individual
JONATHAN H LASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11100 EUCLID AVENUE, CLEVELAND, OH 44106
(216) 844-3601
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
35043240
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221072
UNISON
OH
01
—
000000512667
ANTHEM
OH
01
—
0398270
BCMH
OH
05
—
0398270
—
OH
01
—
363739
WELLCARE
OH
01
—
660752
AETNA
OH
01
—
734684
BUCKEYE
OH
01
—
P00398029
RAILROAD MEDICARE
OH
Enumeration date
10/17/2005
Last updated
01/10/2021
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