Provider Demographics
NPI:1194354555
Name:LAMMOGLIA, CRISTIAN MICHAEL (DPM)
Entity type:Individual
Prefix:DR
First Name:CRISTIAN
Middle Name:MICHAEL
Last Name:LAMMOGLIA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 DETROIT AVE APT 229
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-2769
Mailing Address - Country:US
Mailing Address - Phone:816-244-9579
Mailing Address - Fax:
Practice Address - Street 1:27155 CHARDON RD STE 201
Practice Address - Street 2:
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44143-1166
Practice Address - Country:US
Practice Address - Phone:440-516-8704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-06
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH59.000827213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery