DR. STACY LYNN GENERALOVICH (NPI# 1144286188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144286188 |
| Entity Type | Individual |
| Full Name | DR. STACY LYNN GENERALOVICH |
| Credential | DO |
| Practice Address |
6505 Market St Ste 2100 Boardman OH 44512-3457 |
| Mailing Address |
1 Perkins Sq Akron OH 44308-1063 |
| Practice Telephone | 3307468040 |
| Practice Fax Number | 3307468025 |
| Mailing Telephone | 3307468040 |
| Mailing Fax Number | 3307468025 |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2013-09-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 34.008077 | OH | Allopathic & Osteopathic Physicians |
| Street Address |
6505 MARKET ST STE 2100 |
| City | BOARDMAN |
| State | OH |
| Zip Code | 44512-3457 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467437434 | Denise Lynn Stoneman | Nurse Practitioner | 6505 Market St Ste 2100, Boardman, OH 44512-3457 | 2005-12-13 |
| 1891171849 | Sarah Elizabeth Watkins | Nurse Practitioner | 6505 Market St Ste 2100, Boardman, OH 44512-3457 | 2015-07-31 |
| 1053671669 | Jacqueline Lee Lickliter | Pediatrics | 6505 Market St Ste 2100, Boardman, OH 44512-3457 | 2012-05-17 |
| 1821390741 | Mary J Pascolini | Nurse Practitioner | 6505 Market St Ste 2100, Boardman, OH 44512-3457 | 2010-11-29 |
| 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 | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063904514 | Deanna Marie Bellville | Pediatrics | 6505 Market St Bldg A1, Boardman, OH 44512 | 2018-05-31 |
| 1053671669 | Jacqueline Lee Lickliter | Pediatrics | 6505 Market St Ste 2100, Boardman, OH 44512-3457 | 2012-05-17 |
| 1336381987 | Erin M. Donley | Pediatrics | 6505 Market St, Boardman, OH 44512-3457 | 2009-03-28 |
| 1366680415 | Sangeeta Rani Bhatia | Pediatrics | 8401 Market St, Boardman, OH 44512-6725 | 2009-01-28 |
| 1093996258 | Hi Moon Ahn | Pediatrics | 6505 Market St, Boardman, OH 44512-3457 | 2007-11-16 |
| 1407059983 | Jennifer Manning | Pediatrics | 8401 Market St, Boardman, OH 44512-6725 | 2007-06-11 |
| 1093926693 | Cheryl A Clay | Pediatrics | 6505 Market St, Boardman, OH 44512-3457 | 2007-05-24 |
| 1659418036 | Laura Marie Pesci | Pediatrics | 6505 Market St, Boardman, OH 44512-3457 | 2007-02-01 |
| 1801950068 | Lawrence A Shaffer | Pediatrics | 6505 Market St, Boardman, OH 44512-3457 | 2006-12-21 |
| 1144230459 | Therese Mccullough Linnon | Pediatrics | 6505 Market St, Building C, Suite 212, Boardman, OH 44512-3457 | 2006-08-09 |
| Find all providers in BOARDMAN | ||||
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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.