Individual
JANE A PONTISSO
Active
Individual
JANE A PONTISSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.P.M.
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
36-003276
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2402073
—
OH
01
—
JASP04681
MEDICARE GROUP
OH
Enumeration date
10/16/2006
Last updated
11/05/2007
Update your record
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