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General NPI Number Information
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NPI Number | 1063518371
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Entity Type | Individual
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Provider Name | MARGARITA LASSALETTA MD
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Gender | Female
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 10/26/2012
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Provider Practice Location Address
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Address Line | 185 WADSWORTH RD SUITE 2E
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City | WADSWORTH
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State | OH
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Zip | 44281-8330
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Country | US
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Telephone | 330-336-5046
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Fax | 330-336-5052
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Provider Business Mailing Address
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Address Line | 185 WADSWORTH RD SUITE 2E
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City | WADSWORTH
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State | OH
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Zip | 44281-8330
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Country | US
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Telephone | 330-336-5046
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Fax | 330-336-5052
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 35-067706
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35-067706
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 35-067706
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License Number State | OH
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