Provider Demographics
NPI:1053971200
Name:LAUREN DIGREGORIO DPM
Entity type:Organization
Organization Name:LAUREN DIGREGORIO DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:CARMELLA
Authorized Official - Last Name:DIGREGORIO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:419-202-4789
Mailing Address - Street 1:1502 LEAR INDUSTRIAL PKWY STE 1A
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-1380
Mailing Address - Country:US
Mailing Address - Phone:440-937-5400
Mailing Address - Fax:440-937-5533
Practice Address - Street 1:1502 LEAR INDUSTRIAL PKWY STE 1A
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011-1380
Practice Address - Country:US
Practice Address - Phone:440-937-5400
Practice Address - Fax:440-937-5533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty