Provider Demographics
NPI:1831687888
Name:LANZOLA, EMILY L
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:L
Last Name:LANZOLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5940 OAK POINT RD
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-4100
Mailing Address - Country:US
Mailing Address - Phone:440-988-3705
Mailing Address - Fax:440-988-7433
Practice Address - Street 1:5940 OAK POINT RD
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-4100
Practice Address - Country:US
Practice Address - Phone:440-988-3705
Practice Address - Fax:440-988-7433
Is Sole Proprietor?:No
Enumeration Date:2018-04-25
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.014381207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine