Healthcare Provider Details

I. General information

NPI: 1134221773
Provider Name (Legal Business Name): CHRISTINE CIPOLLETTI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2006
Last Update Date: 10/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 PEARL RD STE.300
CLEVELAND OH
44130-3639
US

IV. Provider business mailing address

6900 PEARL RD STE 300
CLEVELAND OH
44130-3640
US

V. Phone/Fax

Practice location:
  • Phone: 440-884-9000
  • Fax: 440-884-4929
Mailing address:
  • Phone: 440-884-9000
  • Fax: 440-884-4929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number35082867C
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: