DERMATOLOGY CENTRE OF NORTHEAST OHIO LLC NPI 1063565513

NPI Information

DERMATOLOGY CENTRE OF NORTHEAST OHIO, LLC is a specialist in Youngstown, OH. The provider is 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. DERMATOLOGY CENTRE OF NORTHEAST OHIO, LLC NPI is 1063565513. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

960 WINDHAM CT
SUITE 2
YOUNGSTOWN, OH
ZIP 44512
Phone: (330) 758-8866
Fax: (330) 758-4051

The provider's authorized official is Terri L Stilson .
The authorized official title is Practice Manager and has the following contact phone number (330) 758-8866.

The CLIA number assigned to this NPI record is 36D1034794 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 1/19/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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