Provider Demographics
NPI:1972292407
Name:BIASELLA SANTILLO, PAOLA (NP)
Entity Type:Individual
Prefix:
First Name:PAOLA
Middle Name:
Last Name:BIASELLA SANTILLO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2879 ISTRA LN
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44092-1430
Mailing Address - Country:US
Mailing Address - Phone:440-862-8897
Mailing Address - Fax:
Practice Address - Street 1:7965 AUBURN RD
Practice Address - Street 2:
Practice Address - City:CONCORD TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:44077-9701
Practice Address - Country:US
Practice Address - Phone:440-352-2702
Practice Address - Fax:440-352-2702
Is Sole Proprietor?:No
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0032259363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology