Provider Demographics
NPI:1700505492
Name:SCHULLCASSER, JOSEPH (LDO)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:SCHULLCASSER
Suffix:
Gender:M
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2256 WARRENSVILLE CENTER RD.
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-3130
Mailing Address - Country:US
Mailing Address - Phone:216-321-3399
Mailing Address - Fax:216-321-2895
Practice Address - Street 1:2256 WARRENSVILLE CENTER RD.
Practice Address - Street 2:
Practice Address - City:UNIVERSITY HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-3130
Practice Address - Country:US
Practice Address - Phone:216-321-3399
Practice Address - Fax:216-321-2895
Is Sole Proprietor?:No
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician