DERMATOLOGY CENTRE OF NORTHEAST OHIO, LLC (NPI# 1063565513) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063565513 |
| Entity Type | Organization |
| Organization Name | DERMATOLOGY CENTRE OF NORTHEAST OHIO, LLC |
| Practice Address |
960 Windham Ct Suite 2 Youngstown OH 44512 |
| Practice Telephone | 3307588866 |
| Practice Fax Number | 3307584051 |
| Mailing Telephone | 3307588866 |
| Mailing Fax Number | 3307584051 |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. TERRI L STILSON (PRACTICE MANAGER) |
| Authorized Official Telephone | 3307588866 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 35059099 | OH | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0784594 | 05 |
| Street Address |
960 WINDHAM CT SUITE 2 |
| City | YOUNGSTOWN |
| State | OH |
| Zip Code | 44512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609870567 | Anthony L Mehle | Dermatology | 960 Windham Ct, Ste 2, Youngstown, OH 44512-5087 | 2005-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285248740 | Kimberly Vrabel | Counselor | 725 Boardman Canfield Road Road Unit 1 and Unit 2, Boardman, OH 44512 | 2020-09-02 |
| 1043830144 | Steffi Lorraine D'souza | Student in an Organized Health Care Education/Training Program | 8423 Market Street Suite 101 St. Elizabeth Boardman Hos, Boardman, OH 44512 | 2020-04-20 |
| 1427677830 | Shivani Sharma | Family Medicine | 8423 Market Street Suite 101, St Elizabeth Boardman Hospital, Boardman, OH 44512 | 2020-04-15 |
| 1417587825 | Ronny Zetts | Pharmacist | 308 Boardman-canfield Rd, Boardman, OH 44512 | 2020-01-24 |
| 1285105080 | Andrew Dawson | Nurse Practitioner | 883 Boardman Canfield Rd Ste 105, Youngstown, OH 44512 | 2018-12-06 |
| 1700374949 | Adam Leid | Student in an Organized Health Care Education/Training Program | St Elizabeth Boardman Hospital - Medical Education Dept, 8401 Market Street, Boardman, OH 44512 | 2018-04-24 |
| 1528574910 | Herman Frank IIi | Licensed Practical Nurse | 920 Boardman Canfield Road, Boardman, OH 44512 | 2017-12-20 |
| 1730601980 | Stephanie Ann Mathews | Nurse Practitioner | 7600 Southern Blvd #1, Boardman, OH 44512 | 2017-07-10 |
| 1417485079 | Telka Ghobadi | Family Medicine | 8423 Market St., Suite 101, Boardman, OH 44512 | 2017-05-26 |
| 1356797534 | Haroon Hussain Syed | Student in an Organized Health Care Education/Training Program | 8423 Market Street, St. Elizabeth Boardman Hospital, Boardman, OH 44512 | 2016-05-06 |
| Find all providers in zip 44512 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457612525 | Melissa M. Ruta | Specialist | 461 Riverview Dr., Youngstown, NY 14174 | 2012-06-05 |
| 1093986648 | James M Daley | Specialist | 17 N Champion St, Youngstown, OH 44503-1602 | 2008-03-21 |
| 1437177979 | Joel S Enriquez | Specialist | 5500 Market St Ste 119, Youngstown, OH 44512-2616 | 2006-07-17 |
| 1124080239 | Giovanna Vinci-khoury | Specialist | 4970 Belmont Ave, Youngstown, OH 44505 | 2006-04-04 |
| 1467420919 | Anil Choudary Nalluri | Specialist | 5500 Market St, Suite 128, Youngstown, OH 44512-2601 | 2006-03-10 |
| 1215916069 | James Phillip D'apolito | Specialist | 4531 Belmont Ave, Youngstown, OH 44505-1051 | 2006-01-11 |
| 1346234044 | Associates In Anesthesiology, Inc | Specialist | 3622 Belmont Ave, Suite 1, Youngstown, OH 44505-1450 | 2005-09-08 |
| 1205838497 | Pediatric Imaging Associates, LLC | Specialist | 500 Gypsy Ln, Youngstown, OH 44504-1315 | 2005-06-01 |
| 1568464857 | Michael J Miladore | Specialist | 1335 Belmont Ave, Youngstown, OH 44504-1185 | 2005-06-01 |
| 1285637918 | Chander M. Kohli M.d., Inc. | Specialist | 540 Parmalee Ave, Ste 310, Youngstown, OH 44510-1605 | 2005-05-27 |
| Find all providers in YOUNGSTOWN | ||||
| City | YOUNGSTOWN |
| Zip Code | 44512 |
Please comment or provide details below to improve the information on DERMATOLOGY CENTRE OF NORTHEAST OHIO, LLC.
| 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.