Provider Demographics
NPI:1144300450
Name:PARISI, JOSEPH S (OD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:S
Last Name:PARISI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12690 OPALOCKA DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44026
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12690 OPALOCKA DR
Practice Address - Street 2:
Practice Address - City:CHESTERLAND
Practice Address - State:OH
Practice Address - Zip Code:44026
Practice Address - Country:US
Practice Address - Phone:440-729-9546
Practice Address - Fax:440-729-0938
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3194T587152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0290470001OtherDME
T46860Medicare UPIN
PA0432871Medicare ID - Type Unspecified
L9271671Medicare ID - Type UnspecifiedGROUP
0290470001OtherDME