Provider Demographics
NPI:1346310786
Name:LAMANTIA, JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:LAMANTIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4440 RED BANK RD STE 110
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-2177
Mailing Address - Country:US
Mailing Address - Phone:859-292-9176
Mailing Address - Fax:
Practice Address - Street 1:4440 RED BANK RD STE 110
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-2177
Practice Address - Country:US
Practice Address - Phone:859-292-9176
Practice Address - Fax:859-292-9177
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.127338207P00000X
NY149756207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3117504Medicaid