Provider Demographics
NPI:1194084582
Name:RALPH SIEGENTHALER INC
Entity type:Organization
Organization Name:RALPH SIEGENTHALER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:ZANNETTI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:440-442-6969
Mailing Address - Street 1:5584 MAYFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2928
Mailing Address - Country:US
Mailing Address - Phone:440-442-6969
Mailing Address - Fax:440-442-8312
Practice Address - Street 1:5584 MAYFIELD RD
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-2928
Practice Address - Country:US
Practice Address - Phone:440-442-6969
Practice Address - Fax:440-442-8312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-07
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1073261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHU74493Medicare UPIN