Individual
JEROME LAMENDOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15810 DETROIT AVE, LAKEWOOD, OH 44107-3711
(216) 529-1800
(216) 529-3201
Mailing address
30575 EUCLID AVE, WICKLIFFE, OH 44092-1037
(440) 516-3776
(440) 516-3783
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
36-00-2157-L
OH
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0551095
—
OH
Enumeration date
08/11/2005
Last updated
01/24/2011
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