Provider Demographics
NPI:1134108228
Name:DASO, AMY ARSZMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:ARSZMAN
Last Name:DASO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17436 EDGEWATER DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-1120
Mailing Address - Country:US
Mailing Address - Phone:216-228-1537
Mailing Address - Fax:
Practice Address - Street 1:14701 DETROIT AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-4115
Practice Address - Country:US
Practice Address - Phone:216-221-5901
Practice Address - Fax:216-221-5881
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35082206208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2422560Medicaid
OH2422560Medicaid
OH103037Medicare UPIN