MEDICARE: JOHN JOSEPH SANITATO JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0805X	Geriatric Psychiatry Physician	35-075148	OH
2	2084P0800X	Psychiatry Physician	35-075148	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	260050789	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	000000532988	OTHER	OH	ANTHEM
3	4007873	OTHER	OH	AETNA
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689694952
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN JOSEPH SANITATO JR. MD

Provider Business Mailing Address
First Line	:	6900 PEARL RD STE 100
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44130-3640
Country	:	US
Telephone Number	:	216-844-2400
Fax Number	:	216-292-1001

Provider Business Practice Location Address
First Line	:	6900 PEARL RD STE 100
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44130-3640
Country	:	US
Telephone Number	:	216-844-2400
Fax Number	:	216-292-1001

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	02/04/2021

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Directions to “ JOHN JOSEPH SANITATO JR. MD” Practice Location

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