Provider Demographics
NPI:1982897500
Name:SCARLATO, JENNIFER L (OD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:SCARLATO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:L
Other - Last Name:PLUG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:832 GREAT NORTHERN MALL
Mailing Address - Street 2:
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-3300
Mailing Address - Country:US
Mailing Address - Phone:440-777-9904
Mailing Address - Fax:
Practice Address - Street 1:832 GREAT NORTHERN MALL
Practice Address - Street 2:
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070-3300
Practice Address - Country:US
Practice Address - Phone:440-777-9904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5737152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist