Provider Demographics
NPI:1093701138
Name:KRIZMAN, ANASTACIA LAGUNZAD (DO)
Entity Type:Individual
Prefix:DR
First Name:ANASTACIA
Middle Name:LAGUNZAD
Last Name:KRIZMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVENUE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:850 COLUMBIA RD
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-1493
Practice Address - Country:US
Practice Address - Phone:440-250-5737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.007348207R00000X
IN02002549A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN15D1043329OtherCLIA SECONDARY LOCATION
IN000000353052OtherANTHEM PRIMARY LOCATION
IN15D1007700OtherCLIA PRIMARY LOCATION
IN000000374719OtherANTHEM SECONDARY LOCATION
IN200332310AMedicaid
KY64058498Medicaid
INP00213395OtherRAILROAD MEDICARE
INBL6742440OtherDEA PRIMARY LOCATION
INP00213395OtherRAILROAD MEDICARE
IN15D1043329OtherCLIA SECONDARY LOCATION
INH28043Medicare UPIN
IN200332310AMedicaid