Individual
SUSAN LACEY ANTONELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
17876 SAINT CLAIR AVE, CLEVELAND, OH 44110-2602
(216) 383-2222
(216) 298-0241
Mailing address
17876 SAINT CLAIR AVE, CLEVELAND, OH 44110-2602
(216) 383-2222
(216) 298-0241
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN.CNP.023456
OH
Other
Enumeration date
08/15/2018
Last updated
06/20/2019
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