Provider Demographics
NPI:1922003383
Name:LAPERNA, LUCY (DO)
Entity Type:Individual
Prefix:
First Name:LUCY
Middle Name:
Last Name:LAPERNA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:LUCY
Other - Middle Name:
Other - Last Name:MASSULLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 E CAMPUS VIEW BLVD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235
Mailing Address - Country:US
Mailing Address - Phone:614-396-4733
Mailing Address - Fax:614-396-4742
Practice Address - Street 1:3525 OLENTANGY RIVER RD
Practice Address - Street 2:STE 5360
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214
Practice Address - Country:US
Practice Address - Phone:614-340-7747
Practice Address - Fax:614-340-7742
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34005937M207R00000X
OH34.0059372085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00318374OtherRR MEDICARE
OH0996329Medicaid
F93117Medicare UPIN
OH4163232Medicare PIN