Healthcare Provider Details

I. General information

NPI: 1811036395
Provider Name (Legal Business Name): NORTHEAST OHIO FOOT AND WOUND CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 04/29/2024
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8588 E MARKET ST
WARREN OH
44484-2339
US

IV. Provider business mailing address

8588 E MARKET ST
WARREN OH
44484-2339
US

V. Phone/Fax

Practice location:
  • Phone: 330-856-4444
  • Fax: 330-856-9033
Mailing address:
  • Phone: 330-856-4444
  • Fax: 330-856-9033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number36.003129
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberSC005955
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number36.002617
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC003389L
License Number StatePA

VIII. Authorized Official

Name: DR. JAMES J LAPOLLA JR.
Title or Position: PRESIDENT
Credential: DPM
Phone: 330-856-4444