Provider Demographics
NPI:1699547356
Name:LANESE, VINCENT PATRICK JR
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:PATRICK
Last Name:LANESE
Suffix:JR
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 1:1284 BENNETT RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:OH
Mailing Address - Zip Code:44057-1431
Mailing Address - Country:US
Mailing Address - Phone:440-222-1874
Mailing Address - Fax:
Practice Address - Street 1:1284 BENNETT RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:OH
Practice Address - Zip Code:44057-1431
Practice Address - Country:US
Practice Address - Phone:440-222-1874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker