Individual
DOMINIC VINCENT LASTORIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1210 GENESEE AVE, MAYFIELD HTS, OH 44124-1724
(216) 313-0716
Mailing address
1210 GENESEE AVE, MAYFIELD HTS, OH 44124-1724
(216) 313-0716
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN462051
OH
Other
Enumeration date
09/11/2021
Last updated
09/11/2021
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