Healthcare Provider Details

I. General information

NPI: 1033716527
Provider Name (Legal Business Name): CYNTHIA ANN LUKETIC ROMITO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2020
Last Update Date: 10/07/2020
Certification Date: 10/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7290 MAPLE LEAF CT
LIBERTY TOWNSHIP OH
45044-8756
US

IV. Provider business mailing address

7290 MAPLE LEAF CT # CY
LIBERTY TOWNSHIP OH
45044-8756
US

V. Phone/Fax

Practice location:
  • Phone: 440-487-5908
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: