MEDICARE: DR. GARY J CRAPANZANO O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152WC0802X	Corneal and Contact Management Optometrist	3529	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013909894
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY J CRAPANZANO O.D.

Provider Business Mailing Address
First Line	:	7630 BROADVIEW RD
Second Line	:
City	:	PARMA
State	:	OH
Zip	:	44134-6745
Country	:	US
Telephone Number	:	216-642-5500
Fax Number	:	216-642-9829

Provider Business Practice Location Address
First Line	:	7630 BROADVIEW RD
Second Line	:
City	:	PARMA
State	:	OH
Zip	:	44134-6745
Country	:	US
Telephone Number	:	216-642-5500
Fax Number	:	216-642-9829

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	09/10/2010

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