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General NPI Number Information
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NPI Number | 1578602330
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Entity Type | Organization
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Legal Business Name | NORTHEAST OHIO FOOT, ANKLE AND WOUND CENTER, INC
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 05/29/2020
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Provider Practice Location Address
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Address Line | 7264 WARREN SHARON RD
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City | BROOKFIELD
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State | OH
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Zip | 44403-9691
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Country | US
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Telephone | 330-448-6222
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Fax | 330-448-6549
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Provider Business Mailing Address
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Address Line | 8588 E MARKET ST
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City | WARREN
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State | OH
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Zip | 44484-2339
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Country | US
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Telephone | 330-856-4444
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Fax | 330-856-9033
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES J LAPOLLA JR.
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Credential | DPM
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Telephone | 330-448-6222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | SC003389
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 36.002617
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License Number State | OH
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