Provider Demographics
NPI:1043287501
Name:CUGINO, LYNETTE M (MD)
Entity type:Individual
Prefix:
First Name:LYNETTE
Middle Name:M
Last Name:CUGINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:5071 PADDINGTON DOWN RD NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-1578
Mailing Address - Country:US
Mailing Address - Phone:330-418-3868
Mailing Address - Fax:330-433-1666
Practice Address - Street 1:6046 WHIPPLE AVE NW
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-7616
Practice Address - Country:US
Practice Address - Phone:330-433-1200
Practice Address - Fax:330-433-1666
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036098928207R00000X
OH35069454207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2337117Medicaid
OHRE4082881Medicare PIN
OH2337117Medicaid