Provider Demographics
NPI:1770235178
Name:JANUZZI, ROLAND (CPED)
Entity Type:Individual
Prefix:
First Name:ROLAND
Middle Name:
Last Name:JANUZZI
Suffix:
Gender:M
Credentials:CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5819 WHISPERING PINES PL
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-3772
Mailing Address - Country:US
Mailing Address - Phone:440-724-7433
Mailing Address - Fax:
Practice Address - Street 1:207 N LEAVITT RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:OH
Practice Address - Zip Code:44001-1124
Practice Address - Country:US
Practice Address - Phone:440-984-7463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPED.191224L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist