Healthcare Provider Details

I. General information

NPI: 1134047111
Provider Name (Legal Business Name): EMMA OMERZO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

42141 OBERLIN ELYRIA RD
ELYRIA OH
44035-7411
US

V. Phone/Fax

Practice location:
  • Phone: 216-868-8776
  • Fax:
Mailing address:
  • Phone: 330-501-4631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: