Provider Demographics
NPI:1740423771
Name:LINGANNA, SANJAY (MD)
Entity Type:Individual
Prefix:DR
First Name:SANJAY
Middle Name:
Last Name:LINGANNA
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 1:2581 BERKSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44106-3362
Mailing Address - Country:US
Mailing Address - Phone:267-709-1288
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE # G10
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-4551
Practice Address - Country:US
Practice Address - Phone:216-445-6414
Practice Address - Fax:216-445-1007
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09307000207R00000X
PAMD446945207R00000X
OH35.142049207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine