Provider Demographics
NPI:1407097330
Name:DESIATO, LINDSAY CHRISTINE (DO)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:CHRISTINE
Last Name:DESIATO
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 1:9318 STATE ROUTE 14
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:STREETSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:44241-5224
Mailing Address - Country:US
Mailing Address - Phone:330-626-3455
Mailing Address - Fax:330-626-4189
Practice Address - Street 1:9318 STATE ROUTE 14
Practice Address - Street 2:1ST FLOOR
Practice Address - City:STREETSBORO
Practice Address - State:OH
Practice Address - Zip Code:44241-5224
Practice Address - Country:US
Practice Address - Phone:330-626-3455
Practice Address - Fax:330-626-4189
Is Sole Proprietor?:No
Enumeration Date:2009-03-24
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-010422207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine