ADVANCED DERMATOLOGY AND SKIN CANCER CENTER (NPI# 1831187764) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831187764 |
| Entity Type | Organization |
| Organization Name | ADVANCED DERMATOLOGY AND SKIN CANCER CENTER |
| Practice Address |
987 Boardman Canfield Rd Boardman OH 44512-4222 |
| Practice Telephone | 3309658760 |
| Practice Fax Number | 3309659325 |
| Mailing Telephone | 3309658760 |
| Mailing Fax Number | 3309659325 |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | VICKI GRONER (BILLING MANAGER) |
| Authorized Official Telephone | 3309658760 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710274014 | Advanced Dermatology and Skin Cancer Center | Clinical Medical Laboratory | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2011-07-07 |
| 1497912893 | Advanced Dermatology and Skin Cancer Center | Clinical Medical Laboratory | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2008-05-22 |
| 1528147352 | Advanced Dermatology and Skin Cancer Center | Clinical Medical Laboratory | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2006-11-03 |
| Street Address |
987 BOARDMAN CANFIELD RD |
| City | BOARDMAN |
| State | OH |
| Zip Code | 44512-4222 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215923115 | John Raymond Bernat | Specialist | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2005-09-26 |
| 1770092900 | Teresa Marie Shaffer | Nurse Practitioner | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2017-09-20 |
| 1659764108 | Laurie Anne Quattro | Physician Assistant | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2015-03-09 |
| 1710274014 | Advanced Dermatology and Skin Cancer Center | Clinical Medical Laboratory | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2011-07-07 |
| 1093020133 | Mariel Bird | Dermatology | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2010-08-13 |
| 1497912893 | Advanced Dermatology and Skin Cancer Center | Clinical Medical Laboratory | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2008-05-22 |
| 1508062712 | Sarah J Kudelko | Physician Assistant | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2007-06-25 |
| 1528147352 | Advanced Dermatology and Skin Cancer Center | Clinical Medical Laboratory | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2006-11-03 |
| 1396733218 | Pamela Guerriere-kovach | Specialist | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2005-10-13 |
| 1316933260 | Patrick L. Shannon | Specialist | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2005-09-26 |
| Find all providers in the same location | ||||
| 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 |
|---|---|---|---|---|
| 1982149647 | Kymberli Dawn Erevia | Specialist | 104 S. W. Kinkade Road, Boardman, OR 97818 | 2017-01-04 |
| 1861891517 | Elliott Brodzinski | Specialist | 5111 Market St Ste 1, Boardman, OH 44512-2141 | 2014-08-19 |
| 1457559163 | Allied Pain Treatment Center | Specialist | 950 Windham Court, Suite 1, Boardman, OH 44512 | 2007-07-03 |
| 1356317218 | Uma C Perni | Specialist | 7067 Tiffany, Suite 220, Boardman, OH 44514 | 2006-02-28 |
| 1114918133 | John Joseph Buckley Jr. | Specialist | 935 Trailwood Dr, Boardman, OH 44512-5062 | 2005-10-31 |
| 1720078298 | John S Venglarcik | Specialist | 819 Mckay Ct Ste B3, Boardman, OH 44512-5771 | 2005-10-26 |
| 1215923115 | John Raymond Bernat | Specialist | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2005-09-26 |
| 1114920204 | James Armile | Specialist | 8262 South Ave, Boardman, OH 44512-6415 | 2005-05-23 |
| 1679996284 | Douglas Schneider | Specialist | 100 Debartolo Pl Ste 220, Boardman, OH 44512-6095 | 2014-02-03 |
| 1457598898 | Pinnacle Health Concepts, LLC | Specialist | 1280 Boardman Canfield Rd, Ste 6, Boardman, OH 44512-4073 | 2009-01-07 |
| 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.