Healthcare Provider Details

I. General information

NPI: 1154924538
Provider Name (Legal Business Name): EMILY FRANCES CERUTTI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2020
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6835 BROADWAY AVE
CLEVELAND OH
44105-1313
US

IV. Provider business mailing address

4834 WOOD ST
WILLOUGHBY OH
44094-5870
US

V. Phone/Fax

Practice location:
  • Phone: 216-957-1601
  • Fax:
Mailing address:
  • Phone: 440-315-2528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03338050
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: