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Individual

DR. GERALD JOSEPH DAGOSTINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
5404 NORTHFIELD ROAD, MAPLE HTS, OH 44137
(216) 587-6620
(216) 587-6623
Mailing address
5404 NORTHFIELD ROAD, MAPLE HTS, OH 44137
(216) 587-6620
(216) 587-6623

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3716T397
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0632613
OH
01
341617718026
CARE SOURCE
OH
01
5369140001
DME
Enumeration date
08/14/2006
Last updated
07/12/2013
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