Provider Demographics
NPI:1700844719
Name:GEMMA, LORI LYNN (DO)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:LYNN
Last Name:GEMMA
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 1:8054 DARROW RD STE 1
Mailing Address - Street 2:BUILDING D
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-2381
Mailing Address - Country:US
Mailing Address - Phone:330-425-1485
Mailing Address - Fax:330-405-7960
Practice Address - Street 1:7689 SAGAMORE HILLS BLVD
Practice Address - Street 2:
Practice Address - City:SAGAMORE HILLS
Practice Address - State:OH
Practice Address - Zip Code:44067-2960
Practice Address - Country:US
Practice Address - Phone:330-467-8101
Practice Address - Fax:330-468-3948
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2017-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-007700207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2629776Medicaid
OHH90684Medicare UPIN