MEDICARE: NICHOLAS LATTANZIO

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	225100000X	Physical Therapist	PT022266	OH

General Provider Information

NPI Number	:	1982557633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLAS LATTANZIO

Provider Business Mailing Address
First Line	:	8591 CROSSROADS DR
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44514-4382
Country	:	US
Telephone Number	:	330-758-0577
Fax Number	:

Provider Business Practice Location Address
First Line	:	1695 NILES CORTLAND RD NE
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44484-1165
Country	:	US
Telephone Number	:	330-758-0577
Fax Number	:

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

Provider Enumeration Date	:	02/20/2026
Last Update Date	:	02/20/2026

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Directions to “ NICHOLAS LATTANZIO ” Practice Location

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