LAUREN GANDOLFO (NPI# 1356795447) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356795447 |
| Entity Type | Individual |
| Full Name | LAUREN GANDOLFO |
| Credential | D.O. |
| Practice Address |
29343 Woodpark Cir Warren MI 48092-6305 |
| Mailing Address |
6071 W Outer Dr Detroit MI 48235-2624 |
| Practice Telephone | 5173046410 |
| Mailing Telephone | 3139663300 |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2017-05-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
29343 WOODPARK CIR |
| City | WARREN |
| State | MI |
| Zip Code | 48092-6305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881163186 | Katherine Byrd | Behavior Technician | 3691 East 11 Mile Rd., Warren, MI 48092 | 2018-11-15 |
| 1861980302 | Mark Paul Azzo | Home Health Aide | 27605 Walker Ave, Warren, MI 48092 | 2018-04-30 |
| 1144747130 | Joseph Galutan Estrada | Chiropractor | 4846 Marlow Dr, Warren, MI 48092 | 2017-08-29 |
| 1649669425 | Lawrence Mosurak IIi | Chiropractor | 6201 Chicago Road, Warren, MI 48092 | 2015-01-15 |
| 1174911713 | Kimberly A Ott | Nurse Practitioner | 28800 Ryan Rd Suite 320, Warren, MI 48092 | 2015-01-06 |
| 1487071999 | Michele Szandzik | Chiropractor | 2243 East 12 Mile Rd, Warren, MI 48092 | 2014-03-21 |
| 1962827311 | Mouradian Dental Center, D.d.s., P.C. | Dentist | 32500 Mound Rd., Mouradian Dental Center, D.d.s., P.C., Warren, MI 48092 | 2014-02-21 |
| 1639495930 | Debra Kay Wenneman | Physical Therapist | 28776 Ryan Rd, Warren, MI 48092 | 2010-04-12 |
| 1922332923 | Sonia Amirali Pethani | Physical Therapist | 2117 E. Eleven Mile Rd., Warren, MI 48092 | 2009-09-23 |
| 1881822237 | Michael Patrick Walsh | Orthopaedic Surgery | 28800 Ryan Rd Ste 310, Warren, MI 48092 | 2009-06-24 |
| Find all providers in zip 48092 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083239792 | Krutarth Kandarp Pandya | Student in an Organized Health Care Education/Training Program | 1350 East Market Street 7th Floor, Warren, OH 44483 | 2020-06-09 |
| 1902435738 | Peter Alexander Iskander | Student in an Organized Health Care Education/Training Program | 1350 E Market Street, 7th Floor, Warren, OH 44483 | 2020-04-03 |
| 1093344822 | Matthew Jacob | Student in an Organized Health Care Education/Training Program | 1350 East Market Street, 7th Floor, Warren, OH 44483 | 2020-04-03 |
| 1265069967 | Luis Ariel Crespo | Student in an Organized Health Care Education/Training Program | 1350 E Market St Fl 7, Warren, OH 44483-6608 | 2020-03-24 |
| 1720615420 | Cindy Tran | Student in an Organized Health Care Education/Training Program | 1350 E Market St Fl 7th, Warren, OH 44483-6608 | 2020-03-24 |
| 1225679608 | Robert James Robine Jr. | Student in an Organized Health Care Education/Training Program | 8405 Hettenberger Ave, Warren, MI 48093-4968 | 2019-10-07 |
| 1306405527 | Caroline Kwon | Student in an Organized Health Care Education/Training Program | 4 Hardwood Ct, Warren, NJ 07059-2700 | 2019-06-11 |
| 1306309638 | Sameer Raj Joshi | Student in an Organized Health Care Education/Training Program | 1350 East Market Street, Warren, OH 44483 | 2019-04-12 |
| 1033671128 | Gopal A Desai | Student in an Organized Health Care Education/Training Program | 45 Briarwood Dr E, Warren, NJ 07059-6780 | 2019-04-05 |
| 1538656921 | Biswaraj Tharu | Student in an Organized Health Care Education/Training Program | 1350 East Market Street, Trumbull Regional Medical Cent, Warren, OH 44483 | 2018-04-20 |
| Find all providers in WARREN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.