Provider Demographics
NPI:1215659321
Name:CRISCI, DANIEL
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:CRISCI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7922 BARRISTERS CT
Mailing Address - Street 2:
Mailing Address - City:KIRTLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44094-9285
Mailing Address - Country:US
Mailing Address - Phone:440-796-7491
Mailing Address - Fax:
Practice Address - Street 1:7922 BARRISTERS CT
Practice Address - Street 2:
Practice Address - City:KIRTLAND
Practice Address - State:OH
Practice Address - Zip Code:44094-9285
Practice Address - Country:US
Practice Address - Phone:440-796-7491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4996225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist