Provider Demographics
NPI:1033101779
Name:GAGLIANI, ANGELO (OD)
Entity Type:Individual
Prefix:DR
First Name:ANGELO
Middle Name:
Last Name:GAGLIANI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19905 ECHO DR
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44149-6009
Mailing Address - Country:US
Mailing Address - Phone:440-878-9272
Mailing Address - Fax:
Practice Address - Street 1:8251 DAY DR
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5609
Practice Address - Country:US
Practice Address - Phone:440-885-0406
Practice Address - Fax:440-885-0417
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH4838152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
19930OtherCOLE PROVIDER I.D.