Healthcare Provider Details

I. General information

NPI: 1336377555
Provider Name (Legal Business Name): LUCIANA HANNIBAL PH.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2009
Last Update Date: 06/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE DEPARTMENT OF PATHOBIOLOGY, LRI, CLEVELAND CLINIC
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

436 FAIRCHILD AVE
KENT OH
44240-2126
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-8339
  • Fax:
Mailing address:
  • Phone: 330-677-0507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: