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General NPI Number Information
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NPI Number | 1407097330
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Entity Type | Individual
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Provider Name | LINDSAY CHRISTINE DESIATO D.O.
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Gender | Female
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Dates
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Enumeration Date | 03/24/2009
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Last Update Date | 07/11/2012
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Provider Practice Location Address
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Address Line | 9318 STATE ROUTE 14 1ST FLOOR
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City | STREETSBORO
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State | OH
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Zip | 44241-5224
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Country | US
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Telephone | 330-626-3455
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Fax | 330-626-4189
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Provider Business Mailing Address
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Address Line | 9318 STATE ROUTE 14 1ST FLOOR
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City | STREETSBORO
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State | OH
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Zip | 44241-5224
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Country | US
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Telephone | 330-626-3455
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Fax | 330-626-4189
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34-010422
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License Number State | OH
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