Provider Demographics
NPI:1760577365
Name:NERONE, JOANN MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:JOANN
Middle Name:MARIE
Last Name:NERONE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:JOANN
Other - Middle Name:MARIE
Other - Last Name:CLASS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:37432 FREEDOM AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH RIDGEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44039-2875
Mailing Address - Country:US
Mailing Address - Phone:614-579-3779
Mailing Address - Fax:
Practice Address - Street 1:46440 U.S ROUTE 20
Practice Address - Street 2:
Practice Address - City:OBERLIN
Practice Address - State:OH
Practice Address - Zip Code:44074
Practice Address - Country:US
Practice Address - Phone:614-579-3779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5379152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHU96732Medicare UPIN
OH4115893Medicare ID - Type Unspecified