Provider Demographics
NPI:1396757787
Name:LENDER, JOYCE ANN (MD)
Entity type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:ANN
Last Name:LENDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1268 E BROAD ST STE 1
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-6311
Mailing Address - Country:US
Mailing Address - Phone:440-284-1400
Mailing Address - Fax:440-366-1888
Practice Address - Street 1:1268 E BROAD ST STE 1
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-6311
Practice Address - Country:US
Practice Address - Phone:440-284-1400
Practice Address - Fax:440-366-1888
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-05-5705207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0707686Medicaid
OHC03375Medicare UPIN
OHLE0618523Medicare ID - Type UnspecifiedMEDICARE NUMBER