Provider Demographics
NPI:1477617595
Name:CHOY ZANNONI, JEAN S (MD)
Entity Type:Individual
Prefix:DR
First Name:JEAN
Middle Name:S
Last Name:CHOY ZANNONI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JEAN
Other - Middle Name:S
Other - Last Name:ZANNONI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 29302
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44129-0302
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4732 PEARL RD
Practice Address - Street 2:STE 1
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-5106
Practice Address - Country:US
Practice Address - Phone:216-741-2616
Practice Address - Fax:216-741-4377
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-049714207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0559702Medicaid
34139669400OtherBUREAU OF WORKMAN'S COMP
34139669400OtherBUREAU OF WORKMAN'S COMP
OHA80810Medicare UPIN